Fremdblutsparende Maßnahmen bei orthopädischen Eingriffen

Abstract

Major transfusion-free orthopaedic surgery can be performed successfully. This requires advanced planning, good routines and close collaborative team efforts. Since most blood saving techniques reduce blood usage by just 1-2 units, a series of integrated preoperative, intraoperative and postoperative blood saving approaches is required. These include preoperative autologous donation, erythropoietic support, acute normovolemic hemodilution, intraoperative autotransfusion, individualized assessment of anemia tolerance, meticulous surgical techniques and the use of pharmacologic agents for limiting blood loss. For various reasons, we do not recommend the transfusion of wound drainage. This article describes the various methods for bloodless medical care.

Epidemiology of the high-risk population

“…Definitely, one concept to reduce perioperative morbidity and mortality might be to improve the surgical interventions themselves, for example, by using less invasive and improved surgical techniques [10][11][12]. However, recent research has accumulated evidence that not only the surgical procedure itself but at least to the same extent the quality of postoperative care and the quality of complication management are essential for the outcome of the patients.…”