Comparison of blood loss at the donor site & Acute cardiovascular effects by using adrenaline infiltration and topical adrenaline during skin graft harvest

Abstract

Background. Burn surgery is associated with high blood loss to both the donor and recipient site. Although various techniques for reducing intraoperative blood loss have been described, topical adrenaline and adrenaline infiltration have significantly reduced blood loss. The present study compared blood loss to the donor site and acute cardiovascular effects (such as heart rate/ HR and blood pressure/ BP), by using adrenaline infiltration and topical adrenaline while harvesting the skin graft in the same patient, but in a different place. Materials and Methods. It is a prospective study that included 50 patients, all undergoing skin graft harvesting using method 1 and local adrenaline - method 2, in different locations. Blood loss and acute cardiovascular effects were assessed and compared between two methods. Results. Blood loss at the donor site is significantly lower in adrenaline infiltration compared to topical infiltration (4.7±0.6 ml vs 10.4±1.2 ml, p<0.001). Compared to baseline, the mean increase in HR and BP was significantly higher after adrenaline infiltration than topical adrenaline, but for a short period of time. Changes in HR values were larger than in BP. Conclusions. Our study showed that adrenaline infiltration was better than topical adrenaline in conserving blood loss, but acute cardiovascular effects (increased BP and HR) were greater after infiltration, being clinically insignificant and requiring no treatment.

Keywords

• blood loss
• heart rate
• blood pressure
• donor site
• topical adrenaline
• adrenaline infiltration