RESUMO
The study aimed to determine the impact of implementing a patient blood management (PBM) policy during total hip arthroplasty. Firstly, the authors collected retrospective data concerning blood consumption for all patients (N = 577) having undergone total hip arthroplasty between 2009 and 2011, other than for post-traumatic indications. During this period, no coherent blood management rules were in place. Based on the results obtained, a blood transfusion strategy called Patient Blood Management (PBM) was defined and implemented in our department for this type of surgical procedure beginning 2012. The impact of PBM was then analyzed after a 6-month prospective study during 2013/2014 on a cohort of 123 patients. These prospective data demonstrate that PBM significantly improved patient care and reduced the need for allogeneic labile blood transfusions.
Assuntos
Anemia/terapia , Artroplastia de Quadril/métodos , Transfusão de Sangue/métodos , Seleção de Pacientes , Complicações Pós-Operatórias/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia/metabolismo , Anemia/prevenção & controle , Perda Sanguínea Cirúrgica , Transfusão de Sangue Autóloga , Gerenciamento Clínico , Feminino , Hemoglobinas/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Política Organizacional , Complicações Pós-Operatórias/metabolismo , Complicações Pós-Operatórias/prevenção & controle , Guias de Prática Clínica como Assunto , Estudos Prospectivos , Estudos Retrospectivos , Transplante HomólogoRESUMO
Bone allografts can be used in any kind of surgery involving bone from minor defects to major bone loss after tumour resection. This review describes the various types of bone grafts and the current knowledge on bone allografts, from procurement and preparation to implantation. The surgical conditions for optimising the incorporation of bone are outlined, and surgeon expectations from a bone allograft discussed.