[Foreign blood saving measures in orthopedic surgery].
Major transfusion-free orthopaedic surgery can be performed successfully. This requires advanced planning, good routines and close collaborative team efforts. Since most blood saving techniques reduce blood usage by just 1-2 units, a series of integrated preoperative, intraoperative and postoperative blood saving approaches is required. These include preoperative autologous donation, erythropoietic support, acute normovolemic hemodilution, intraoperative autotransfusion, individualized assessment of anemia tolerance, meticulous surgical techniques and the use of pharmacologic agents for limiting blood loss. For various reasons, we do not recommend the transfusion of wound drainage. This article describes the various methods for bloodless medical care.
Reize
P
P
Orthopädische Universitätsklinik, Hoppe-Seyler-Strasse 3, 72076 Tübingen. patrik.reize@med.uni-tuebingen.de
Wülker
N
N
D000328:Adult; D000740:Anemia / Q000209:etiology; D001780:Blood Coagulation Tests; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous / Q000191:economics / Q000379:methods; D002648:Child; D002986:Clinical Trials as Topic; D000075202:Contraindications; D003362:Cost-Benefit Analysis; D004322:Drainage; D004920:Erythropoiesis; D004921:Erythropoietin / Q000008:administration & dosage*; D006400:Hematocrit; D006438:Hemodilution / Q000379:methods*; D006452:Hemoglobinometry; D006801:Humans; D007430:Intraoperative Care; D033221:Jehovah's Witnesses; D015201:Meta-Analysis as Topic; D019637:Orthopedic Procedures; D011300:Preoperative Care; D012307:Risk Factors; D013997:Time Factors; D014947:Wounds and Injuries / Q000097:blood
D004921:Erythropoietin