Polysaccharide hemostatic system reduces blood loss in high-body-mass-index patients undergoing simultaneous bilateral total knee arthroplasty.

Autor: Aktas E; Department of Orthopaedics, Ankara Onkoloji Training and Research Hospital, 2. Ortopedi Klinigi, Demetevler, Ankara, Turkey. drerdem2007@gmail.com, Kaya AV, Deveci MA, Ozler K, Akdeniz H, Yildirim H
Jazyk: angličtina
Zdroj: Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association [J Orthop Sci] 2012 Jul; Vol. 17 (4), pp. 432-6. Date of Electronic Publication: 2012 Apr 05.
DOI: 10.1007/s00776-012-0221-0
Abstrakt: Background: To investigate the efficacy of a topically applied hemostatic agent used to reduce blood loss in patients undergoing simultaneous bilateral total knee arthroplasty (TKA).
Methods: Thirty-two patients (5 male, 27 female) mean age 65 ± 9.3 (46-80) undergoing single-stage bilateral TKA were enrolled in the study and divided in two groups. Groups 1 and 2 consisted of patients with body mass index (BMI) <30 and >30, respectively. Polysaccharide hemostatic agent (PHA; 3 g) was applied topically to the right knees of each patient intraoperatively. The left knees were used as controls. A negative suction drain was used and the effect of PHA and BMI on postoperative bleeding was evaluated.
Results: Blood loss was significantly higher (p = 0.027, r = 0.397) for patients with higher BMI. Treatment by local application of PHA to potential bleeding sites significantly reduced blood loss-314 ± 151 ml (50-600) for the right knees versus 468 ± 140 ml (150-700) for the left knees (p = 0.007) in group 1; 420 ± 251 ml (100-900) for the right knees versus 620 ± 229 ml (350-1125) for the left knees (p = 0.036) in group 2. Blood loss reduction between the right and left knees was no different between the two groups (p = 0.173).
Conclusions: By reducing blood loss and the need for postoperative blood transfusion in patients with high BMI, PHA can be of value as adjuvant therapy in new blood-management procedures in major joint-replacement surgery.
Databáze: MEDLINE
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