Complications and risk management in the use of the reaming-irrigator-aspirator (RIA) system: RIA is a safe and reliable method in harvesting autologous bone graft

Autor: Patrick Haubruck, Gerhard Schmidmaier, Matthias Miska, Michael C. Tanner, Julian Ober, Raban Heller
Rok vydání: 2017
Předmět:
Male
Blood transfusion
Medical Doctors
medicine.medical_treatment
Health Care Providers
lcsh:Medicine
Logistic regression
Biochemistry
Fats
0302 clinical medicine
Postoperative Complications
Medicine and Health Sciences
Medicine
030212 general & internal medicine
Femur
Medical Personnel
lcsh:Science
Musculoskeletal System
030222 orthopedics
Multidisciplinary
Bone Transplantation
Trauma center
Hematology
Middle Aged
Lipids
Clinical Laboratory Sciences
Professions
Area Under Curve
Tissue and Organ Harvesting
Engineering and Technology
Female
Anatomy
Management Engineering
Research Article
Adult
medicine.medical_specialty
Pain
Surgical and Invasive Medical Procedures
Aspirator
Transplantation
Autologous
03 medical and health sciences
Diagnostic Medicine
Physicians
Humans
Blood Transfusion
Tibia
Hemoglobin
Skeleton
Aged
Surgeons
Risk Management
business.industry
Transfusion Medicine
lcsh:R
Biology and Life Sciences
Proteins
Surgery
Transplantation
Health Care
Logistic Models
ROC Curve
Fractures
Ununited
People and Places
lcsh:Q
Population Groupings
business
Complication
Zdroj: PLoS ONE
PLoS ONE, Vol 13, Iss 4, p e0196051 (2018)
ISSN: 1932-6203
Popis: Background Autologous bone grafting (ABG) remains the gold standard for augmentation of bone defects. The RIA system has become more prevalent, but evidence regarding risk management and complications remain scarce. This study presents the risk management and complications associated with RIA in the largest single-center case series to date. Methods All records, operative notes, lab data and radiographs of patients receiving a RIA procedure at Heidelberg´s University Hospital between 01/01/2010 and 31/12/2016 were reviewed. Multivariate logistic regression models adjusting for clinically relevant covariates were used to examine the respective relevance regarding the presence and absence of prolonged postoperative pain (PPP). Results A total of 341 RIA procedures on 306 patients were performed at our level-1 trauma center. The femur was the main donor site (98.53%; N = 336) whereas only in 1.47% (N = 5) the tibia was utilized. A total of 11 patients showed a relevant loss of hemoglobin requiring blood transfusion. A total of 22 patients suffered from PPP directly associated with the RIA procedure resulting in prevalence of 6.45%. The 6 major complications in our study were of diverse origin and all intraoperative complications took place in the early phase of the RIA procedure in our center (2010–2013). Our data revealed influence of sex (p = 0.0459) and age (p = 0.0596) on the criterion PPP. The favored model including sex and age resulted in an AUC of 66.2% (CI: 55.5%-76.9%). Conclusion Perioperative blood loss remains a prevalent complication during RIA reaming. In addition, PPP occurs with a prevalence of 6.45%. This study showed a complication rate of 1.76%, emphasizing RIA´s overall safety and furthermore highlighting the need for vigilance in its application and prior extensive hands-on training of surgeons. Level of Evidence: II.
Databáze: OpenAIRE
Externí odkaz: