Unwashed wound drainage blood: What are we giving our patients?

E. P. Southern, M. H. Huo, J. R. Mehta, K. J. Keggi

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Wound drainage blood was collected after total joint arthroplasty was completed in 13 consecutive patients. Peripheral blood samples were collected in the recovery room and at 6 hours postoperatively for all 13 patients. A standard enzyme-linked immunosorbency assay was done to quantify tumor necrosis factor-α, interlenkin-1α interleukin-6, and interleukin-8 levels in the samples. At 6 hours postoperatively, the levels of cytokines were elevated significantly in the peripheral and drainage blood serum. In particular, the drainage blood serum had the most dramatic increase for all cytokines, which was significant. Reinfusion of unwashed filtered postoperative wound drainage blood has been shown nut to be entirely benign; pyrogenic transfusion reaction is the most commonly reported adverse effect, but hemodynamic instability with hypotension and even myocardial infarction have been reported. The cause of these adverse events has not been defined clearly, but may be secondary to the infusion of cytokines. The present study showed the presence and significant elevation of the cytokine levels in the wound drainage blood. A comprehensive review of the literature revealed that unwashed drainage blood is a relatively dilute blood product lacking normal clotting factors and having numerous other undesirable components that may mitigate against its routine use in lieu of predeposited autologous or homologous blood. This is of interest because there is evidence indicating that wound drainage blood reinfusion may be unnecessary in total joint arthroplasty when autologous blood is available. Use of drains in this surgery also may be unnecessary and has been shown to increase the amount of blood loss and the need for transfusion.v

Original languageEnglish (US)
Pages (from-to)235-246
Number of pages12
JournalClinical Orthopaedics and Related Research
Issue number320
StatePublished - 1995

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Drainage
Wounds and Injuries
Cytokines
Arthroplasty
Joints
Recovery Room
Nuts
Blood Coagulation Factors
Serum
Interleukin-8
Hypotension
Interleukin-6
Tumor Necrosis Factor-alpha
Hemodynamics
Myocardial Infarction
Enzymes

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Unwashed wound drainage blood : What are we giving our patients? / Southern, E. P.; Huo, M. H.; Mehta, J. R.; Keggi, K. J.

In: Clinical Orthopaedics and Related Research, No. 320, 1995, p. 235-246.

Research output: Contribution to journalArticle

Southern, E. P. ; Huo, M. H. ; Mehta, J. R. ; Keggi, K. J. / Unwashed wound drainage blood : What are we giving our patients?. In: Clinical Orthopaedics and Related Research. 1995 ; No. 320. pp. 235-246.
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