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Randomized Controlled Trial
. 2007 Apr;31(2):235-9.
doi: 10.1007/s00264-006-0159-y. Epub 2006 Jun 8.

Autotransfusion drains in total knee replacement. Are they alternatives to homologous transfusion?

T Abuzakuk  1 , V Senthil Kumar, Y Shenava, C Bulstrode, J A Skinner, S R Cannon, T W Briggs
Affiliations
Randomized Controlled Trial

Autotransfusion drains in total knee replacement. Are they alternatives to homologous transfusion?

T Abuzakuk et al. Int Orthop. 2007 Apr.

Abstract
in English, French

We prospectively randomised 104 consecutive patients undergoing primary cemented total knee arthroplasty into two groups of 52 patients each, with one group to receive a standard suction drain (Redivac) and the other, an autologous transfusion drain (Bellovac). Randomisation was achieved using the software programme MINIM: , which was set to randomly allocate patients to either of the two groups based on their age, sex and body mass index (BMI). All procedures were performed under pneumatic tourniquet. Drains were released in the recovery room 20 min after surgery and removed 24 h following surgery. Blood collected in the standard suction drain (control group) was discarded, while blood collected in the autologous transfusion drains (study group) was transfused unwashed back to the patient within 6 h of collection. Thirteen patients (25%) in the study group had two or more units of homologous blood transfused in addition to the blood collected postoperatively and re-transfused (average: 438 ml). Twelve patients (23%) in the control group had two or more units of homologous blood transfused. No sepsis, transfusion reactions or coagulopathies were associated with the autologous blood transfused in the study group. The use of the autologous transfusion system (Bellovac) proved to be safe but failed to reduce the need for postoperative homologous blood transfusion following uncomplicated total knee arthroplasty.

Nous avons étudié, de façon prospective randomisée, 104 patients consécutifs ayant bénéficié d’une prothèse totale du genou cimentée. Chaque patient a reçu soit un drain aspiratif standard (Redivac) soit un drain permettant une retransfusion (Bellovac). 52 patients ont été randomisés dans chaque groupe à l’aide d’un programme software avec une excellente concomitance entre l’âge, le sexe et le BMI. Toutes les interventions ont été réalisées avec garrot. Les drains ont été mis en aspiration en salle de réveil, 20 minutes après la fin de l’acte chirurgical. Ces drains ont été ôtés 24 heures après la chirurgie. Le sang collecté dans le drain standard a été rejeté alors que le drain Bellovac a permis de récupérer le sang, le retransfuser sans lavage six heures après l’intervention. 39 patients (25%) dans le groupe standard ont eu deux, ou plus de deux, unités sanguines de transfusion en plus du sang récupéré dans le drain (438 ml en moyenne). 12 patients (23%) dans le groupe contrôle ont eu deux, ou plus de deux, transfusions. Il n’y a pas eu d’infection, de réaction sanguine après ré-infusion du sang du redon. L’utilisation d’un système de réutilisation du sang de type Bellovac n’entraîne pas de problèmes particuliers mais il ne permet pas de diminuer la nécessité de transfusions post-opératoires après une prothèse totale du genou standard sans complication.

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References

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