In the discussion presented in this paper, two things are unjustifiably mixed: the demonstration of fat droplets in orthopedic wound blood, and the occurrence of membrane vesicles from cell lysis or extracorporeal circulation that can cause cerebral microembolization and postoperative neuropsychological disturbances. Biochemically, both substances represent “lipids,” but the characteristics of fat and membrane lipids are different. Unfortunately, this mix-up is often not due to innocent not-knowing. The clinical relevance of fat in orthopedic wound blood awaits clarification ― and this paper may support such studies ― but clarification would also strongly benefit from discrimination of the scientific facts.
– E. Hansen.