Wound Infiltration with Adrenaline Reduces Blood Loss and Transfusion during Internal Fixation of Femoral Nonunion In Adults

Abstract

Femoral shaft nonunion is associated with soft tissue fibrosis which prolongs dissection. This results in significant blood loss and increased blood transfusion rate. To reduce intra-operative blood loss and transfusion rate, we evolved a procedure which was assessed for ease of application, efficacy and safety. Sixty-one patients were assigned to two groups and underwent open reduction and internal fixation for femoral non-union. We infiltrated the wounds with adrenaline-saline 1:200,000 and normal saline in groups 1 and 2 respectively. No intra-operative adverse effects were attributable to the use of adrenaline. There were four cases of superficial wound dehiscence without obvious wound infection in group 1 and none in group 2. There was a significant reduction in intra-operative blood loss and transfusion rate in group 1. In conclusion, our data suggest that wound infiltration with adrenaline is effective in reducing transfusion rate and intraoperative blood loss during open reduction and internal fixation of femoral non-union. Nigeria Journal of Orthopaedics and Trauma Vol. 7 (2) 2008: pp. 54-56