ABSTRACT
AIM: We have carried out an observational study to determine the pre-operative risk factors for transfusion in patients undergoing implantation of a hip prosthesis. METHOD: 47 patients were recruited to the study. The following parameters were recorded: peri-operative transfusions, infusions, blood and secretion losses, re-transfusions and other operative variables. In addition, patient-specific data (age, body mass index, co-existing conditions, haemoglobin) were determined. The data were grouped by transfusions and re-transfusions and submitted to statistical analysis. RESULTS: The transfusion incidence in knee endoprosthesis implantation procedures was low at 25.5 %. Age above 74 years, ASA 3 and 4 were identified as significant risk factors for transfusion. If the significant risk groups identified in this study are left aside, a transfusion incidence of 5.6 % is found. CONCLUSION: For the implantation of an artificial hip joint, we recommend autologous blood donation only for patients with ASA 3. For other patients it is recommended that homologous banked blood (2 units of cross-matched concentrated red cells) be held in readiness.
Subject(s)
Arthroplasty, Replacement, Hip , Blood Transfusion , Osteoarthritis, Hip/surgery , Perioperative Care , Aged , Aged, 80 and over , Blood Donors , Blood Loss, Surgical/physiopathology , Blood Transfusion, Autologous , Blood Volume/physiology , Female , Hematocrit , Hemoglobinometry , Humans , Male , Middle Aged , Osteoarthritis, Hip/blood , Prospective Studies , Prosthesis Design , Retreatment , Risk FactorsABSTRACT
When an infection occurs in the incisional area following surgery where foreign materials (i. e. endoprostheses, metal plates or plastic meshes) are implanted, a revision may become necessary because an infection in the area of the implant and involvement of the implant itself cannot be ruled out. In the case of a mitigated erysipelas, cultures taken during the revision seldom show bacterial growth. The disease progresses because surgery does not solve the problem of a weakened immune system and lymph stasis; on the contrary, it usually deteriorates the situation. A high dose antibiotic regimen is recommended as therapy for the mitigated erysipelas instead of an operative revision orally given. levofloxacin has proven to be successful reducing the recurrence rate. The course of two patients with mitigated erysipelas is represented for example in form of case studies. The patients were underwent several surgical revisions. But we had not to explant the endoprostheses at all. Finally both patients were treated with levofloxacin without further relapses.
