Does autotransfusion from a contaminated trauma laparotomy field increase the risk of complications?

Am J Surg. 2022 May;223(5):988-992. doi: 10.1016/j.amjsurg.2021.10.006. Epub 2021 Oct 11.


Background: Autotransfusion (AT) in trauma laparotomy is limited by concern that enteric contamination (EC) increases complications, including infections. Our goal was to determine if AT use increases complications in trauma patients undergoing laparotomy with EC.

Methods: Trauma patients undergoing laparotomy from October 2011-November 2020 were reviewed. Patients were excluded if they did not receive blood in the operating room, did not have a full thickness hollow viscus injury, or died <24 h from admission. AT and non-AT patients were matched. Outcomes were compared.

Results: 185 patients were included, 60 received AT, and 46 pairs were matched. After matching, demographics were similar. No differences were noted in septic complications (33 vs 41%, p = 0.39), overall complications (59% vs 54%, p = 0.67), or mortality (13 vs 6%, p = 0.29).

Conclusions: AT use in contaminated trauma laparotomy fields was not associated with a higher rate of complications.

Keywords: Autotransfusion; Cell salvage; Contamination; Infection; Laparotomy; Trauma.

MeSH terms

  • Abdominal Injuries* / complications
  • Abdominal Injuries* / surgery
  • Blood Transfusion, Autologous
  • Humans
  • Laparotomy* / adverse effects
  • Retrospective Studies
  • Viscera