Blood Loss in Orthopedic Surgery: A Historical Review. Issue 1 (March 2017)

• Record Type: Journal Article
• Authors: Fafalak, Marc; Cushner, Fred D.
• Is Part Of: Techniques in orthopaedics. Volume 32:Issue 1(2017)
• Publication Date: 2017-03
• Subjects: blood loss -- orthopedic surgery -- transfusion avoidance -- blood management; Orthopedics -- Periodicals; 617.47
• DOI: 10.1097/BTO.0000000000000203
• Languages: English
• ISSNs: 0885-9698

Abstract

Abstract : Joint arthroplasty since its inception has been associated with substantial blood loss and this blood loss has led to high allogenic transfusion rates as well as the development of hemarthrosis. Once hemarthrosis occurs, joint infection, wound complications, and increased recovery time also occur. The administration of allogenic blood products is not without risk and has been associated with incorrect blood crossmatching, transmission of both bacterial and viral pathogens, anaphylactic reactions, immunosuppression, and fluid overload. Postoperative anemia coupled with the resulting increase in transfusion requirements increases morbidity, mortality, length of hospital stay as well as overall health care costs. These factors have driven orthopedic surgeons to modify existing technology as well as propose new devices and protocols in an effort to maximize positive outcomes for their patients. The result is a robust, multimodal approach to blood conservation which is constantly changing and improving. This article chronicles the history of blood conservation techniques, analyzes their advantages and disadvantages and brings to light the cutting edge technology which modern medicine has produced to combat this problem.