title: Efficacy of intraoperative red blood cell salvage and autotransfusion in the treatment of acetabular fractures.
abstract: OBJECTIVE
  To determine if cell saver (CS) use in patients with acetabular fractures reduces the volume or rate of allogeneic blood transfused intraoperatively and postoperatively and if this translated to a decrease in blood-related charges to the patient.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Level 1 trauma center.
  
  
  METHODS
  One hundred eighty-six patients with operatively treated acetabular fractures.
  
  
  METHODS
  All patients underwent open reduction internal fixation of their acetabular fracture. The decision to use CS was at the surgeon's discretion.
  
  
  METHODS
  The volume and rate of intraoperative and postoperative allogeneic blood transfused and blood-related charges were evaluated.
  
  
  RESULTS
  CS was used in 60 cases (32%), and the average volume of blood autotransfused was 345 mL. No differences were observed in the rates (58.3% vs 48%, P = 0.1883) or the mean volumes (770 vs 518 mL, P = 0.0537) of intraoperative and postoperative allogeneic blood transfusions between the CS and the non-CS groups. Total blood-related charges in the CS group were significantly higher than that in the nonCS group ($1958 vs $694, P < 0.0001). Subanalyses based on fracture pattern, injury severity score, body mass index, days to surgery, and estimated blood loss were performed. In each subanalyses, no differences were observed in intraoperative and postoperative transfusion rates and volumes, and total blood-related charges were higher in the CS groups.
  
  
  CONCLUSIONS
  In the routine use of CS in acetabular surgery, there was no reduction in the volume or rate of allogeneic blood transfused intraoperatively or postoperatively. However, blood-related charges were significantly increased.
authors.affiliation: Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, NC 28203, USA. brian.scannell@carolinas.org
authors.forename: Brian P
authors.initials: BP
authors.lastname: Scannell
authors.forename: Bryan J
authors.initials: BJ
authors.lastname: Loeffler
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Bosse
authors.forename: James F
authors.initials: JF
authors.lastname: Kellam
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Sims
mesh_terms: D000077:Acetabulum / Q000293:injuries* / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001804:Blood Transfusion, Autologous / Q000379:methods*; D003131:Combined Modality Therapy; D017707:Erythrocyte Transfusion / Q000379:methods*; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D050723:Fractures, Bone / Q000628:therapy*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult