INTRAOPERATIVE BLOOD SALVAGE IN EXCISIONAL BURN SURGERY - AN ANALYSISOF YIELD, BACTERIOLOGY, AND INFLAMMATORY MEDIATORS

The diminution of intraoperative hemorrhage remains a fundamental goal of the burn surgeon. We hypothesized that intraoperative blood salvag e during burn excisions would be feasible if predicated on yield, bact eriology, and concentration of inflammatory mediators in the washed pr oduct. Reinfusion of culture-positive blood has a clear precedent in t he trauma literature. Eight operations with immediate and complete col lection of shed blood into a cell-saver device were prospectively stud ied. A median salvage rate of 43% of total shed red blood cells was es timated to have been recovered. Actual volumetric measurement of intra operative blood loss was achieved. Bacterial contamination was consona nt with the abdominal trauma experience. The levels of C3a, C5a, TNF a lpha, and IL-1 beta in the final cell-saver product were all found to be at clinically insignificant levels.