ALBUMIN-IMPREGNATED POLYESTER VASCULAR PROSTHESIS FOR ABDOMINAL AORTIC-SURGERY - AN IMPROVEMENT

Aim: To compare the peroperative blood loss and the postoperative syst emic inflammatory reaction in patients receiving either a Vasculour II Albumin pre-impregnated prosthesis (VA group, n = 32) or a preclotted Vasculour II prosthesis (V group, n = 33) for elective surgery of the abdominal aorta. Setting: University Hospital. Design: Prospective, r andomised study. Methods: Peroperative blood loss was measured over tw o different periods: Phase from the beginning of the operation to the completion of the proximal anastomosis, when blood loss cannot be rela ted to the model of prosthesis implanted and phase II after the comple tion of the proximal anastomosis to the end of the operation. Postoper ative blood loss was evaluated by the determination of the retroperito neal drainage volume over a period of 2 days immediately following the operation. The presence of periprosthetic fluid was measured with ech ography at days 4, 9, 30 and 60. The postoperative systemic inflammato ry reaction was evaluated by measuring the sedimentation rate and the C reactive protein levels daily from day 1 to day 9, and at days 14, 2 1, 28, 45, and 60, and by measuring the body temperature daily from da y 1 to day 9. Results: No significant differences of peroperative bloo d loss were observed. The same proportion of patients (35%) in both gr oups received homologous transfusion. The mean number of units of homo logous blood transfused per patient was respectively 0.77 and 0.91 for the VA and the V group. The retroperitoneal drainage volume and the p ercentage of patients with periprosthetic fluid did not differ signifi cantly. No significant differences in systemic postoperative inflammat ory reaction were observed. Conclusion: There were no benefits in usin g albumin-impregnated prosthesis as opposed to preclotted prosthesis i n terms of peroperative and postoperative blood loss, or by looking at the incidence of homologous blood transfusion. However, the glutarald ehyde cross-linked albumin did not induce any systemic inflammatory re action.