Post-operative Cell Salvage (PCS)
We would also encourage you to use the Handbook for Transfusion Medicine
Post-operative cell salvage is routinely used in some areas of surgical practice. This technique involves the collection of post-operative blood loss into a wound drain which is then either filtered and returned to the patient or washed prior to re-infusion. The use of post-operative cell salvage has developed due to the availability of simple, cost-effective equipment
The collection and re-infusion of autologous red blood cells provides an important contribution to limiting and supporting the appropriate use of allogeneic (banked) blood. However, it is only one facet of a comprehensive approach to safe, effective and appropriate blood transfusion practice.
Autologous Blood Transfusion Drainage systems may be used in elective and/or emergency Orthopaedic procedures but unwashed re-infusion systems are best used when the expected blood loss is between 500 and 1000ml. There is some preliminary evidence that re-infusion of the unwashed drainage has a beneficial immuno-stimulatory effect and might reduce postoperative infections. (The Lancet, Vol 363, March 27, 2004)
The use of autologous transfusion is at the discretion of the orthopaedic surgeon and anaesthetist and the process should be discussed with the patient pre-operatively whenever possible and documented accordingly. Training and competency assessment of recovery and ward nursing staff in the use of postoperative salvage devices is essential.
Autologous transfusion may be accepted for use by Jehovah Witnesses, but must be discussed pre-operatively with the individual and their decision documented accordingly.
The collection of salvaged blood must be accurately documented and completed within the timeframes (6 hours), or as recommended by the manufacturer. The American Association of Blood Banks guidelines can be used as an additional reference (American Association of Blood Banks (AABB), Standards for Perioperative Autologous Blood Collection and Administration (2nd Edition) 2005)
Contraindications must be considered and the Manufacturer’s protocols should be referred to.
This page was last reviewed on 06/01/2009