Academic Journal of Surgery 2016. 3(3-4):38-41.

Evaluation of Pre- and Post-operative Hemoglobin in Patients with Maxillofacial Injuries
Hamid Reza Eftekharian, Mohammad Talebi, Shamsadin Ahzan, Mojtaba Neydavoodi, Hossein Daneste


Background: In the past decades, a significant increase has been observed in head and face traumas bleeding during and after surgery is one of the most important and dangerous factors for patients. This study was performed to assess the bleeding amount in patients during maxillofacial surgeries and the necessity of blood transfusion.

Methods: In this cross-sectional study, 441 patients were enrolled, of which 83.2% and 16.8% were male and female, respectively. To compare the patients’ mean hemoglobin concentration before and after surgery, paired t-test was used. Furthermore, to compare the mean hemoglobin concentration and mean intraoperative bleeding between males and females, independent t-test was used. The significance level was set as 0.05 for all tests.

Results: Results showed that the mean difference of hemoglobin concentration before and after surgery in patients of the study had a significant difference (P < 0.001). The amount of blood loss during surgery showed no significant difference between males and females (P > 0.050).

Conclusions: The results of this study demonstrated that there was a decrease in mean hemoglobin concentration after surgery, and also, the amount of blood loss in patients during surgery was not high enough for blood transfusion. However, it should be considered that to prevent any problem during surgery, assessing patients with anemia before surgical operations is necessary.


Pre-operative hemoglobin; Post-operative hemoglobin; Maxillofacial injuries

Full Text:



Jurkiewicz MJ, Stephen J, Krizek TJ, Ariyan S. Plastic surgery: Principles and practice. Philadelphia, PA: Mosby-Year Book; 1990. p. 531-9.

Fonseca RJ, Dexter Barber H, Powers MP. Oral and Maxillofacial Trauma. 4th ed. Philadelphia, PA: Elsevier/ Saunders; 2012.

Andersson L, Kahnberg KE, Pogrel MA. Oral and maxillofacial surgery. New York, NY: John Wiley & Sons; 2012.

Kalantar Motamedi MH, Shams MG. Maxillofacial Fractures: incidence, etiology and treatment, a 5-year study. J Mil Med 2003; 5(3): 207-10. [In Persian].

van Hoof RF, Merkx CA, Stekelenburg EC. The different patterns of fractures of the facial skeleton in four European countries. Int J Oral Surg 1977; 6(1): 3-11.

Karkouti K, Wijeysundera DN, Yau TM, Beattie WS, Abdelnaem E, McCluskey SA, et al. The independent association of massive blood loss with mortality in cardiac surgery. Transfusion 2004; 44(10): 1453-62.

Beattie WS, Karkouti K, Wijeysundera DN, Tait G. Risk associated with preoperative anemia in noncardiac surgery: A single-center cohort study. Anesthesiology 2009; 110(3): 574-81.

Jans Q, Bandholm T, Kurbegovic S, Solgaard S, Kjaersgaard-Andersen P, Johansson PI, et al. Post-operative anemia and early functional outcomes after fast-track hip arthroplasty: a prospective cohort study. Transfusion 2016; 56(4): 917-25.

Babaei A, Kalantar Hormozi A, Mozaffari N, Gharahkhani S. Epidemiology of maxillofacial fractures in referral patient to beast, 15 Khordad & Shahrivar Hospital in 2002-2003. Ann Mil Health Sci Res 2004; (2): 347-52. [In Persian].

Dolman RM, Bentley KC, Head TW, English M. The effect of hypotensive anesthesia on blood loss and operative time during Le Fort I osteotomies. J Oral Maxillofac Surg 2000; 58(8): 834-9.

Nosrati K, Babaei S, Ashrafi Moshkabadi J. A survey of mandibular fracture regions of patients of Boualisina,Shafa, Nime shaban hospital in Sari from 2005 until 2006. Journal of Ghasr-e-Baran 2009; 1(1): 37-41. [In Persian].

Wedgwood JJ, Thomas JG. Peri-operative haemoglobin: An overview of current opinion regarding the acceptable level of haemoglobin in the peri-operative period. Eur J Anaesthesiol 1996; 13(4): 316-24.

Carson JL, Hill S, Carless P, Hebert P, Henry D. Transfusion triggers: A systematic review of the literature. Transfus Med Rev 2002; 16(3): 187-99.

Wang JK, Klein HG. Red blood cell transfusion in the treatment and management of anaemia: the search for the elusive transfusion trigger. Vox Sang 2010; 98(1): 2-11.

Dhariwal DK, Gibbons AJ, Kittur MA, Sugar AW. Blood transfusion requirements in bimaxillary osteotomies. Br J Oral Maxillofac Surg 2004; 42(3): 231-5.

Gong SG, Krishnan V, Waack D. Blood transfusions in bimaxillary orthognathic surgery: Are they necessary? Int J Adult Orthodon Orthognath Surg 2002; 17(4): 314-7.

Samman N, Cheung LK, Tong AC, Tideman H. Blood loss and transfusion requirements in orthognatic surgery. J Oral Maxillofac Surg 1996; 54(1): 21-4.

Moenning JE, Bussard DA, Lapp TH, Garrison BT. Average blood loss and the risk of requiring perioperative blood transfusion in 506 orthognathic surgical procedures. J Oral Maxillofac Surg 1995; 53(8): 880-3.

Ueki K, Nakagawa K, Marukawa K, Yamamoto E. Le Fort I osteotomy using an ultrasonic bone curette to fracture the pterygoid plates. J Craniomaxillofac Surg 2004; 32(6): 381-6.

Panula K, Finne K, Oikarinen K. Incidence of complications and problems related to orthognathic surgery: a review of 655 patients. J Oral Maxillofac Surg 2001; 59(10): 1128-36.

Yu CN, Chow TK, Kwan AS, Wong SL, Fung SC. Intra-operative blood loss and operating time in orthognathic surgery using induced hypotensive general anaesthesia: prospective study. Hong Kong Med J 2000; 6(3): 307-11.

Choi BK, Yang EJ, Oh KS, Lo LJ. Assessment of blood loss and need for transfusion during bimaxillary surgery with or without maxillary setback. J Oral Maxillofac Surg 2013; 71(2): 358-65.

Nath A, Pogrel MA. Preoperative autologous blood donation for oral and maxillofacial surgery: an analysis of 913 patients. J Oral Maxillofac Surg 2005; 63(3): 347-9.


  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.