REDUCING TRANSFUSION WASTAGE DURING PELVIC TRAUMA SURGERY: SAVING BLOOD AND SAVING LIVES

Advances in operative techniques have reduced blood loss during pelvic and acetabular trauma surgery. Modern transfusion guidance is aimed at reducing blood transfusions and wastage of blood products. We aimed to assess the impact of introducing a new blood ordering protocol for pelvic trauma procedures on blood product usage and potential wastage. We reviewed case notes, blood ordering and packed red cells (PRC) transfused for patients undergoing pelvic surgery pre-protocol (Jul 2022-Mar 2023) and post-protocol introduction (Jul 2023-Mar 2024). Patients were sub-grouped into three distinct categories based on their operative procedure: percutaneous pelvic fixation, internal pelvic fixation and acetabular fracture fixation. 104 patients undergoing pelvic and acetabular fracture surgery were included. Patient demographics between the two groups were similar. Blood ordering and usage (median) for each operative group was as follows: Percutaneous pelvic fixation pre-protocol had 4 units PRC crossed-matched and 2 units transfused, post-protocol had 0 units cross-matched and 0 units transfused (p<0.05). Internal pelvic fixation pre-protocol had 4 units cross-matched and 0 units transfused, post-protocol and 2 units cross-matched and 0 unit transfused (p<0.05). Acetabular fracture fixation pre-protocol had 3 units cross-matched and 1 unit transfused, post-protocol had 2 units cross-matched and 0 units transfused (p<0.05) We conclude, the introduction of a more conservative blood ordering schedule for pelvic trauma surgery reduces the overall number of units cross-matched peri-operatively, as well as the number of unutilised units. This saves time and money by reducing unnecessary cross-matching of units and prevents potential wastage of this precious NHS resource.