title: Management of blood loss in periacetabular osteotomy.
abstract: The aim of this study was to determine the efficacy and cost-effectiveness of the use of predonation of autologous blood for the periacetabular osteotomy. We carried out a retrospective single surgeon series study looking at patient demographics, intraoperative blood loss, volume of red cells returned (by cell salvage and allogenic/autologous transfusion), and comparing pre- and postoperative haemoglobin levels in those that predonated and those that did not. One hundred and twenty-two procedures were performed on 107 patients between 1996 and 2005. An initial audit (22 procedures) revealed high wastage (45% returned) of allogenic blood. A predonation protocol was initiated and subsequently 100 procedures in 91 patients were performed. In 82 procedures, the patients were eligible for predonation. A total of 226 units of autologous blood were predonated and 92% was used. Only 13 of these patients (16%) required additional allogenic transfusion for unforeseen excessive blood loss intraoperatively. A set protocol for predonation reduces the need for allogenic transfusion and involves minimal wastage. In a procedure which has significant blood loss, we suggest that preoperative autologous donation is a safe and cost effective method of managing blood loss.
authors.affiliation: Department of Orthopaedics, Bristol Royal Infirmary, Bristol, UK.
authors.forename: N S
authors.initials: NS
authors.lastname: Atwal
authors.forename: G
authors.initials: G
authors.lastname: Bedi
authors.forename: B J A
authors.initials: BJ
authors.lastname: Lankester
authors.forename: D
authors.initials: D
authors.lastname: Campbell
authors.forename: M F
authors.initials: MF
authors.lastname: Gargan
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D001782:Blood Donors; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous / Q000191:economics; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D010027:Osteotomy / Q000191:economics; D055815:Young Adult