Reducing Hospital Stay and Enhancing Wound Healing Through Intraoperative Cell Salvage in Spine Surgery

Abstract

Significant blood loss during spine surgery often necessitates allogeneic blood transfusion (ABT), which poses clinical and logistical challenges, including immune reactions, infection risks, and supply constraints. This retrospective cohort study assessed the clinical efficacy of intraoperative cell salvage (ICS) in reducing dependence on ABT and improving patient outcomes at Malaysia Government General Hospital (GH), Malaysia. Data from 72 patients who underwent spine surgeries between January 2023 and December 2024 were analysed. Participants were divided into two groups: 36 patients received ICS and 36 received standard transfusions. Comparative analyses using t-tests and chi-square tests evaluated transfusion requirements, wound healing, haemoglobin (Hb) trends, recovery time, hospital stay, and cost parameters. The ICS group demonstrated significantly shorter hospital stays (M = 8.4 days) compared to the non-ICS group (M = 16.9 days; p < .001), as well as faster recovery (M = 6.0 vs. 13.4 days; p = .001) and superior wound-healing outcomes (p < .001). No significant difference was observed in postoperative Hb levels or intraoperative packed red blood cell use, suggesting equivalent hematologic recovery between groups. Although the reduction in transfusion requirement was not statistically significant (p = .108), the trend favoured ICS. These findings indicate that ICS enhances clinical efficiency by promoting faster recovery, improved wound healing, and reduced hospital stay without compromising safety or haemoglobin stability. The results support broader integration of ICS into perioperative blood management in high-blood-loss spine surgeries, particularly in resource-constrained healthcare systems.