Sep 13

Efecto de la retirada del manguito de isquemia sobre las necesidades transfusionales en el paciente intervenido de artroplastia primaria de rodilla / Effect of removing the ischaemia tourniquet on the transfusion needs of the patient undergoing primary knee arthroplasty

Fuente
Este artículo es originalmente publicado en:
De:
Rev Esp Cir Ortop Traumatol. 2015 Nov-Dec;59(6):394-9. doi: 10.1016/j.recot.2015.05.010. Epub 2015 Jul 31
PMID: 26239865 DOI: 10.1016/j.recot.2015.05.010

[PubMed – in process]

 

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Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved
Resumen

Objetivo

Conocer la influencia del momento de la retirada del manguito de isquemia en la necesidad de transfusiones sanguíneas en las artroplastias primarias de rodilla y su influencia en las complicaciones postoperatorias.

Material y método

Fueron analizadas 201 artroplastias primarias de rodilla retrospectivamente. Se dividieron en 2 grupos: el grupo A (101 pacientes), en el que se retiró el manguito antes del cierre quirúrgico, y el grupo B (100 pacientes), en el que se retiró tras el cierre. Se compararon las transfusiones sanguíneas (medidas en concentrados de hematíes) llevadas a cabo por ambos grupos, contrastándolas con el tiempo quirúrgico, así como las complicaciones posquirúrgicas.

Resultados

La media de concentrados de hematíes transfundidos en el grupo A fue de 0,62, mientras que en el grupo B fue de 0,61 (p=0,831). El tiempo medio quirúrgico en el grupo A fue de 111min, y en el grupo B, de 98min (p<0,05), no existiendo relación entre el tiempo quirúrgico y los concentrados de hematíes transfundidos (p=0,055). Las complicaciones posquirúrgicas en el grupo A fueron 8, y en el B, 10 (p=0,69).

Discusión

No hubo diferencias entre retirar el manguito de isquemia antes o después del cierre quirúrgico, ni en las necesidades transfusionales ni en las complicaciones posquirúrgicas. Tradicionalmente las mayores pérdidas sanguíneas al retirar el manguito antes del cierre han sido explicadas por el mayor tiempo quirúrgico que se requiere; sin embargo, este hecho no se relacionó con mayores necesidades transfusionales en nuestro estudio, ni con mayores complicaciones posquirúrgicas.

Abstract

Objective

To determine the influence of the timing of the removal of the ischaemia tourniquet on the transfusion needs in primary knee arthroplasty and its influence on post-operative complications.

Material and method

A retrospective analysis was performed on 201 primary knee arthroplasties. The patients were divided into 2 groups: group A (101 patients), where the tourniquet was removed before surgical closure, and group B (100 patients), where the tourniquet was removed after the surgical closure. A comparison was made of the blood transfusions (pools of red corpuscles) received by both groups, along with the surgical time, and the post-operative complications.

Results

The mean number of packed red cells transfused in group A was 0.62, while in the group B it was 0.61 (P=.831). The mean time in the surgery in group A was 111min, and in group B it was 98min (P<.05), with no significant difference between the surgical time and the number of packed cells transfused (P=.055). The post-operative complications in the group A were 8, and in the B were 10 (P=.79).

Discussion

There were no differences between removing the tourniquet before or after surgical closure or in the transfusion needs or in the post-operative complications. Traditionally, the greater blood loss due to the removal of the tourniquet before surgical closure has been explained as due to the longer surgery time required. However, in the present study, this fact was not associated with greater transfusion needs, or with more post-operative complications.

Palabras clave
Artroplastia, Rodilla, Isquemia, Transfusión
Keywords
Arthroplasty, Knee, Ischaemia, Transfusion

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