Firoozabadi Reza, Swenson Alan, Kleweno Conor, Routt Milton C
Orthopaedics and Sports Medicine, UW Medicine, University of Washington, Seattle, WA.
J Orthop Trauma. 2015 Aug;29(8):349-53. doi: 10.1097/BOT.0000000000000292.
To determine if intraoperative autologous transfusion using a Cell Saver (CS) was routinely indicated for open reduction internal fixation (ORIF) of acetabular fractures, and if so, was there a difference between differing surgical approaches.
Retrospective single-center cohort study.
University Level 1 trauma center.
PATIENTS/PARTICIPANTS: One hundred forty-five consecutive acetabular fractures using intraoperative autologous transfusion, either treated with an anterior ilioinguinal or a posterior-based Kocher-Langenbeck approach, were compared.
Use of CS in ORIF acetabular cases.
CS utilization and CS blood return for acetabular ORIF. Mean intraoperative blood loss between the 2 approaches.
CS blood was returned in 29 of the 145 total cases [23/65 anterior (ilioinguinal approach) and 6/80 posterior approach (Kocher-Langenbeck)]. Mean intraoperative blood loss was 786 mL for the anterior approach and 485 mL for the posterior approach. Subgroup analysis identified anterior approach as the only risk factor for elevated blood loss and CS blood return.
CS is not indicated for routine use when performing ORIF of the acetabulum. Use of the CS may be warranted with anterior approaches if large amounts of blood loss are anticipated.
Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
确定在髋臼骨折切开复位内固定术（ORIF）中使用细胞回收机（CS）进行术中自体输血是否为常规操作，若如此，不同手术入路之间是否存在差异。
回顾性单中心队列研究。
一级大学创伤中心。
患者/参与者：比较了连续145例使用术中自体输血的髋臼骨折患者，这些患者采用了前路髂腹股沟入路或后路Kocher-Langenbeck入路进行治疗。
在髋臼ORIF病例中使用CS。
髋臼ORIF中CS的使用情况和CS回输血量。两种入路之间的平均术中失血量。
145例患者中，29例有CS回输血（前路髂腹股沟入路23例/65例，后路Kocher-Langenbeck入路6例/80例）。前路入路的平均术中失血量为786 mL，后路入路为485 mL。亚组分析确定前路入路是失血量增加和CS回输血的唯一危险因素。
在进行髋臼ORIF时，不建议常规使用CS。如果预计会大量失血，前路入路时使用CS可能是合理的。
预后水平II。有关证据水平的完整描述，请参阅作者指南。
