Erythrocytes and proinflammatory mediators in wound drainage

Background and Objectives: Retransfusion of shed blood collected after oper ation has become popular, but recent reports of side effects led to a searc h for possible causes. Materials and Methods: In a randomized study of 28 p atients undergoing total hip arthroplasty, shed blood was collected in Solc otrans, Orth-Evac, and ordinary Redon drainage. Osmotic fragility was measu red and electron-microscopic pictures of erythrocytes from selective sample s were taken. Serotonin, prostaglandin E-2 (PGE(2)), and histamine were mea sured with enzyme-linked immunosorbent assays. Results: Higher osmotic frag ility of erythrocytes collected with Solcotrans appeared to be due to ACD w hich was used only with that system. Serotonin concentrations did not diffe r significantly. However, there was a great increase in histamine (Solcotra ns 477.7; Orth-Evac 344.0, Redon drainage 453.1 nmol/ml) and PGE(2) (Solcot rans 1,908.3, Orth-Evac 1,225.0, Redon drainage 2,666.7 mu g/ml) in shed bl ood compared with venous blood (histamine 9.5 nmol/l, PGE(2) 4.2 mu g/ml). Conclusion: Unwashed wound drainage blood collected after operation contain s levels of proinflammatory mediators that can account for the reported sid e effects.