Oxidized Regenerated Cellulose Can Reduce Hidden Blood Loss after Total Hip Arthroplasty: A Retrospective Study

ABSTRACT

Background: There is a large amount of hidden blood loss (HBL) after total hip arthroplasty (THA), but the effective and safe methods to reduce HBL are still controversial. Methods: Sixty-nine consecutive patients who underwent THA in our hospital from January 2015 to December 2015 were analyzed retrospectively. The patients were divided into two groups, Group A (THA without oxidized regenerated cellulose) and Group B (THA with oxidized regenerated cellulose). Demographics, perioperative laboratory values, intraoperative data, blood loss, transfusion rate, transfusion reactions, and surgical complications were collected and analyzed. Results: A total of 37 (54%) patients used oxidized regenerated cellulose (ORC) in operation. The total blood loss (TBL), postoperative blood loss (PBL), hemoglobin (Hb) loss, and hidden blood loss (HBL) in group B were significantly lower than in group A. Conclusions: The use of ORC to fill the bone surface and soft tissue gap before incision closure can effectively reduce HBL and may be a potential treatment for blood prevention after THA.

Keywords::

• oxidized regenerated cellulose
• total hip arthroplasty
• hidden blood loss
• hemostasis

DECLARATION OF INTEREST

The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.

ACKNOWLEDGMENTS

Authors' contribution: Ji-Qi Wang processing data and writing article, Lu-Ying Chen and Bing-Jie Jiang collecting data, You-Ming Zhao operating all total hip arthroplasty.

MATH FORMULA

$$\begin{array}{ccc}\hfill \mathrm{formula}1,\mathrm{EBV}\left(\mathrm{L}\right)& =& \mathrm{k}{1}^{*}\mathrm{height}{\left(\mathrm{m}\right)}^3\hfill \\ & & +{\mathrm{k}2}^{*}\mathrm{weight}\left(\mathrm{kg}\right)+\mathrm{k}3\hfill \end{array}$$where k1 = 0.3669, k2 = 0.03219, and k3 = 0.6041 for males, and k1 = 0.3561, k2 = 0.03308, and k3 = 0.1833 for females. $$\begin{array}{c}\hfill \mathrm{formula}2,\mathrm{TBL}\left(\mathrm{L}\right)=\mathrm{EBV}{\left(\mathrm{L}\right)}^{*}\left(\mathrm{Hc}{\mathrm{t}}_{\mathrm{pre}}-\mathrm{Hc}{\mathrm{t}}_{\mathrm{post}}\right)\\ \hfill \mathrm{Hc}{\mathrm{t}}_{\mathrm{ave}}+\mathrm{TV}\left(\mathrm{L}\right)\end{array}$$$$\begin{array}{c}\hfill \mathrm{formula}3,\mathrm{HBL}\left(\mathrm{ml}\right)=\mathrm{TBL}{\left(\mathrm{L}\right)}^{*}1000\\ \hfill -\mathrm{VBL}\left(\mathrm{ml}\right)-\mathrm{PBL}\left(\mathrm{ml}\right)\end{array}$$$$\begin{array}{c}\hfill \mathrm{formula}4,\mathrm{H}{\mathrm{b}}_{\mathrm{loss}}\left(\mathrm{g}/\mathrm{L}\right)=\mathrm{H}{\mathrm{b}}_{\mathrm{pre}}-\mathrm{H}{\mathrm{b}}_{\mathrm{post}}\end{array}$$$$\begin{array}{c}\hfill \mathrm{formula}5,\mathrm{Hc}{\mathrm{t}}_{\mathrm{loss}}\left(\mathrm{g}/\mathrm{L}\right)=\mathrm{Hc}{\mathrm{t}}_{\mathrm{pre}}-\mathrm{Hc}{\mathrm{t}}_{\mathrm{post}}\end{array}$$where Hct_pre and Hb_pre is the initial preoperative Hct an Hb, Hct_post and Hb_post is the Hct and Hb on the third day after operation, and Hct_ave is the average of the Hct_pre and Hct_post.

ETHICAL APPROVAL

Compliance with Ethical Standards. “All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of Second Affiliated Hospital of Wenzhou Medical University and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required”

Additional information

Funding

This study was funded by Natural Science Foundation of Zhejiang Province (LY15H060009)