Einfluss von Wunddrainage und Aprotiningabe auf den perioperativen Blutverlust bei der Endoprothetik des Hüftgelenkes
LicenseStandard (Fassung vom 03.05.2003)
Introduction: The extent of perioperative (intraoperative and postoperative) hemorrhage is a risk and a cost factor of total hip arthroplasty. The aim of this study was to determine the influence of postoperative wound drainage (Redon system) and systemic administration of Aprotinin on loss of blood. Method: In a prospective, randomized study 81 coxarthrosis patients undergoing primary hip replacement were recruited. Divided into 4 groups a) 2,5 mio I.U. Aprotinin were administered intraoperatively or b) a placebo and c) a wound drainage system was applied or c) not. The intra- and postoperative blood loss was calculated from ultrasound measurement of wound hematoma and the amount of blood collected in the Redon bottles. Results: Aprotinin did not display a significant effect on perioperative blood loss (p=0,75). The "drainage group" had an average blood loss of 1201 ml when Aprotinin and of 1223 ml when placebo was administered. In the "no drainage group" the results were 596 ml and 554 ml respectively. Wound drainage had a significant impact on blood loss (p<0,001). In the "Aprotinin group" average blood loss with drainage system was 1201 ml, without it 596 ml, in the "Placebo group" 1223 ml and 554 ml respectively. Conclusion: In primary arthroplasty of the hip there was no significant influence of Aprotinin on perioperative blood loss. Wound drainage enhanced significantly, i.e. about 100%, perioperative blood loss as compared with wounds without drainage. Rates of complications were equal in both groups. Thus, the results seem to suggest that in hip arthroplasty blood loss might be reduced by not using Redon wound drainage systems but that administration of Aprotinin was not able to show a clinical benefit.
Subject HeadingsAprotinin [GND]