Artikel
A new bipolar blood sealing system vs. a conventional regimen for total knee arthroplasty – results of a prospective matched-pair study
Suche in Medline nach
Autoren
Veröffentlicht: | 13. Juni 2005 |
---|
Gliederung
Text
Introduction
Reduced intra- and perioperative blood loss is an important quality factor in modern Total Knee Arthroplasty (TKA). In a prospective matched pair study visible blood loss during and after TKA should be evaluated.
Materials and Methods
A cohort of 20 consecutive patients with use of Bipolar Sealer 5.0, TissueLink, USA (BPS) during surgery was selected and blood loss was recorded intraoperatively, postoperatively, and at time of drain removal.
The cohort was matched for age and gender with 20 patients without BPS (control) but were otherwise treated exactly the same way. Average age was 72 years, 14 patient were male, 26 female.
Results
BPS yielded a significant reduction of 28.4% blood loss (p<0.003). Compared with the postoperative blood loss, the intra-operative loss was negligible in the BPS group. The blood loss significantly started to differ among the groups after Intermediate Care stay (p<0.001).
Both groups had the same normal preoperative Hb concentrations. BPS produced a smaller Hb reduction at discharge. However, among the control group 10 homologous erythrocyte concentrate packs had to be administered (BPS: 2). Additionally, suction needed to be set to zero in 5 patients in the controls due to rapid effusion (BPS: 0).
Discussion
BPS effectively reduces the postoperative blood loss after TKA. It decreases the probability for allogenic transfusion by factor 5 and for overall transfusion of stored blood from 39% to 5%. BPS can reduce blood loss the same as Aprotinin, yet without its side effects. It deserves consideration in a fast recovery regimen.