BLOOD MANAGEMENT IN ORTHOPAEDIC SURGERY

Blood management in orthopaedic surgery has become an essential component in modern surgical practice,aiming to minimize the need for allogeneic blood transfusions and improve patient outcomes. Blood transfusions, though lifesaving, are associated with several risks, including infections, immune reactions, iron overload, and increased hospital stay.Effective blood management strategies in orthopaedic surgery focus on optimizing preoperative blood conditions, reducing anticipated blood loss, and utilizing the patient's own blood or blood substitutes. Key elements in reducing transfusion requirements include the correction of preoperative anemia (erythrocyte shock),assessing anticipated and acceptable blood loss, and tailoring transfusion thresholds to individual patient needs. Methods to reduce blood transfusion include preoperative optimization of erythrocyte stock through iron supplementation, erythropoiesisstimulating agents, and autologous blood donation. Intraoperatively, techniques such as minimally invasive surgery, tranexamic acid, haemostatic agents, and cell salvage systems are employed to minimize blood loss. Additionally, the use of blood substitutes, such as haemoglobin-based oxygen carriers and perfluorocarbons, presents potential alternatives to allogeneic blood. Overall,blood management strategies in orthopaedic surgery aim to enhance patient safety, reduce transfusion-related risks, and optimize recovery. By minimizing blood loss and optimizing the use of the patient's own blood, orthopaedic surgeons can reduce the complications associated with transfusions and improve clinical outcomes in surgeries like total hip replacements (THR), total knee replacements (TKR), and major trauma surgeries.