In a Total Knee Arthroplasty (TKA) there are 3 forms of blood loss:
Visible blood loss from the surgical field; wound drainage, and blood loss into the tissues (hidden bleeding). The mean calculated blood loss is 1474 ml; the mean hidden blood loss is 735 ml i.e. hidden blood loss is 50% of the total loss, making the true loss following TKA twice the volume usually recorded. Blood loss into the tissue can lead to local inflammation, potentially extending pain discomfort and delay in tissue healing. SeraSeal™ would significantly reduce all three forms of blood loss in a TKA procedure while promoting wound healing. Transfusion of blood loss in total hip and knee arthroplasty: Orthopaedic surgery, especially spine surgery and arthroplasty surgery, is associated with excessive bleeding and a high observed need for blood transfusion. In routine hip arthroplasty and total knee arthroplasty, the prevalence of allogenic red blood (RBC) transfusion ranges between 21% to 70%, with a mean range of 45%.
Allogenic RBC transfusion risks are:
- Transfusion-related lung injury
- Immune dilution
- Transmission of pathogens
In multiple studies of hip and knee arthroplasty intra and post-operative blood loss mean is 1222.7 ml and 574.3 ml, respectively, with a mean surgical time of 2 h + 0.5 h. Even though knee arthroplasty is performed with a tourniquet and the intraoperative blood loss is minimal, it is significant for postoperative blood loss. Even when Tranexamic acid (anti-fibrinolytic) is employed to reduce blood transfusion, the rate of transfusion is still 16% for total hip and knee arthroplasty.
Risk factors: preoperative HGB concentration, BMI, and operative time have a direct effect on blood loss and transfusion. All these risk factors and the employment of Tranexamic acid still have significant blood loss and the need for blood transfusion. SeraSeal™ significantly reduces the amount of blood loss, since hemostasis is achieved in seconds, is effective to arrest bleeding from the bone marrow, and is effective in all forms of coagulopathy.
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