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Autotransfusions Increasingly Popular

Photo from Drew Holsapple

Drew Holsapple sets up an autotransfusion machine, which separates and cleans blood, during surgery at Mease Countryside Hospital.

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BY JOHN TISCHNER

SPECIAL TO THE SUNCOAST NEWS

Published: August 8, 2008

Platelet gel. It has been around since the 1970s but recently has been gaining in popularity. It is widely used around the globe as an effective treatment modality for various surgical procedures and for chronic, non-healing wounds.

The gel, and intra-operative autotransfusion, although separate procedures, are the use of one's own blood and platelets before and during surgical procedures.

Drew Holsapple is a licensed practical nurse and a certified autotransfusionist. The Florida native, who was born in Clearwater and lived most of his life in Ozona, now is a Dunedin resident. He is a graduate of Tarpon Springs High School and the Pinellas Vocational Technical Institute.

Holsapple, 34, is a youthful, athletic-looking man with a short blond crew cut and ruddy complexion. Wearing blue scrubs, he spends most of his working days in the hospital operating rooms of Morton Plant Mease Countryside, Mease Dunedin, Morton Plant North Bay in New Port Richey and the Spring Hill Regional Hospital, among others. Also on his 24-hour call list are several day-surgery centers.

He works for Suncoast Perfusion Services Inc. of Ft. Myers for which he also does marketing.

His responsibility as an autotransfusionist is to collect the patient's blood lost during surgery, reprocess it, and return it to the patient during the surgery, a procedure called autotransfusion.

"A suction line is connected from the sterile field (surgical site) to my machine. The blood from the surgery is collected in a reservoir called a cadiotemy," Holsapple says. The blood is spun in a centrifuge at 5,600 rpm to separate the red blood cells.

" The packed red blood cells are collected on one side of the machine and the waste goes into a bag on the other side of the unit. The good blood products are then washed with a saline solution, and sent through an intravenous transfer back into the patient," says Holsapple.

He monitors the process while interacting with the physicians, nurses and the anesthesiologists. He works during the entire surgical procedure, which can run from two to four hours or more, he said.

Most of the surgeries are scheduled in advance, but when Holsapple is called on an emergency, he phones ahead to alert the operating room staff. "I show the nurses how to hook up my machine while I get there. My window sometimes is only a half hour."

A perioperative blood management company, Suncoast Perfusion Services, says autotransfusion eliminates the risk of transmittable diseases and transfusion errors, costs less than blood bank products, cuts blood loss, and eliminates the waiting period for preoperative donation, among other benefits.

Autotransfusion is used heavily during vascular, gynecology and obstetric, and spinal surgeries where blood loss is heaviest.

Holsapple performs another important procedure, processing platelet gel, which is also used during surgeries. Its popularity has been on the rise, he said.

Prior to a surgical procedure, he draws 55cc's of the patient's blood. It is then spun in a centrifuge that separates the platelets from the red blood cells. The cells are then mixed with an activator that turns the platelets into a gel.

"The process (when applied) puts up the first scaffold of the healing cascade, a healing response you get for healing damaged tissue," explains Holsapple.

The gel is applied to the incision during wound closing and sometimes is sprayed directly into the wound cavity. "It reduces post-op bleeding and reduces scarring and adhesions," he says.

It is said to also accelerate healing, fight infection and minimize swelling.

The gel is used often in open-heart surgery, says Holsapple. "It's your body's own natural healing substance. It lessens the chance of bodily (organ) rejection."

According to the U.S. Department of Health & Human Services' Office of Disease Prevention and Health Promotion, in one study, wounds treated with the platelet gel were more than 81 percent closed after 17 days compared with 57 percent closure for wounds treated with antibiotic ointment or a dressing.

Platelet gel is also popular with veterinarians who use it during animal surgery.

"It is widely used, you just don't hear much about it," says Holsapple.

Rob Reifert is a business manager at Morton Plant Mease Countryside Hospital. He says the hospital has been contracting with Suncoast Perfusion for quite a few years. He notes the rise in usage of platelet gel that, he says, requires a written order from the surgeon.

Regarding its effectiveness, Reifert says, "We are still looking at conclusive studies of the benefits of it."

As a matter of fact, Holsapple says, the platelet gel has become more popular than the autotransfusion.

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