Factors infuencing blood loss after osteosynthesis of trochanteric fractures
Authors:
Stanislava Imrichová; Radoslav Morochovič; Miroslav Kitka; Rastislav Burda
Authors‘ workplace:
Department of Traumatology, Faculty of Medicine, University of P. J. Šafárik and L. Pasteur University Hospital in Košice
; Klinika úrazovej chirurgie LF UPJŠ a UNLP Košice, Slovenská republika
Published in:
Úraz chir. 23., 2015, č.2
Overview
Introduction:
Using closed suction drainage after hip fracture surgery is still controversial. The aim of its use is the reduction of postoperative wound haematoma formation, but on the other hand its use increases morbidity due to higher risk of wound infection. It would be advisable to use suction drains in patinets with higher risk of postoperative wound haematoma formation.
Objective:
To evaluate the volume of postoperatively drained blood in group of older pacients whose trochanteric fracture was stabilized with dynamic hip screw (DHS). Secondary objective was comparing drained blood volumes according to selected risk factors.
Methods:
A prospective observational study of 202 pacients in the age of 65 years and older fixed with DHS for trochanteric fracture between 2008 - 2012. The volume of blood loss collected into the closed suction drainage (Redon drain) was measured within 48 hours after surgery. Evaluated risk factors were: preinjury anti-platelet and/or anti-coagulant medication, body mass index (BMI), American Society of Anesthesiologists classification (ASA), type of fracture, type of ane-sthesia, surgeon´s experience with surgical technique and size of DHS implant.
Results:
The mean volume of drained blood was 130,7 ml (SD 94,7). Mean blood loss was greater in patients operated by less experienced surgeons (mean 158,14 ml) in comparison to experienced ones (123,3 ml, p = 0,02) and treated with longer DHS plate (four or five - hole plate) in comparison to shorter (three - hole plate) (148,0 vs 102,7 ml, p <0,01). Preinjury anti-platelet and anti-coagulant medication, ASA score, BMI, type of anesthesia and type of fracture had no influence on vo-lume of postoperatively drained blood.
Conclusion:
Greater postoperative blood loss can be expected in the case of using longer DHS plates and in surgery performed by less experienced surgeon.
Key words:
Trochanteric Fractures, Dynamic hip screw, Postoperative blood loss, Postoperative suction drainage.
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Surgery Traumatology Trauma surgeryArticle was published in
Trauma Surgery
2015 Issue 2
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