Liquid gold: A discussion of the significance of using intra-operative cell salvage in hip and knee arthroplasty

Blood management is a vital component of a patient’s journey in the perioperative environment. There is a call to incorporate intra-operative cell salvage (ICS) into blood management protocols across hospitals in Australia where invasive and major surgeries have the potential to result in massive blood loss. Donated blood (allogeneic blood), despite its highly valued use in major blood loss events, poses risks and potential complications making cell salvage an attractive viable option in hip and knee arthroplasty. ICS is the process of returning the patient’s own blood (autologous blood) back into its systemic circulation. Autologous blood is collected from blood lost by the patient during surgery and has proven to have fewer complications and more benefits when compared to donated blood. Currently, ICS is still not widely used in many hospitals in Australia and its associated costs continue to be a deterrent to hospitals integrating it into their blood management services. Despite this, many studies have proven that ICS may not just be superior to donated blood in many ways, it may also prove to be cost-efficient when one looks at the compounding results of better patient outcomes.