Academic Journal of Surgery 2016. 3(1-2):2-6.

Blood Products Use in Bimaxillary Orthognathic Surgeries: A Retrospective Study
Hamidreza Eftekharian, Shourangiz Dadain, Ehsan Aliabadi, Reza Tabrizi

Abstract


Background: The purpose of this study was to determine the consumption of blood products during orthognathic surgeries by age, sex, blood group, operation time, and the amount of blood loss.
Methods: This is a retrospective cohort study. Patients who underwent bimaxillary osteotomy were studied. The study focused on types and amount of blood loss, blood products used, and change in patient’s hemoglobin (Hb) and hematocrit (HCT). Patients’ demographic data, blood type, and duration of surgery were variables of the research.
Results: A total of 133 patients (52 males and 81 females) with a mean age of 22.950 ± 4.241 years formed the study population. Average blood loss was 556.32 ± 245.05 ml and the average operating time was 259.96 ± 51.56 minutes. Results demonstrated that duration of the surgical and blood loss in males was higher than females. The mean of Hb and HCT levels before surgeries was 13.56 ± 1.30 and 40.47 ± 4.30, respectively, which significantly (P < 0.001) decreased to 11.969 ± 1.200 and 35.782 ± 3.800 1 day after the operations. The transfused blood products consisted of packed cells (5.4%), fresh frozen plasma (37.3%), and hydroxyethyl starch (57.3%). The percentage of patients who did not receive any transfusion was generally higher in the positive blood types than negative ones, with the highest percentage being in the AB+ group.
Conclusions: A risk of using blood products particularly packed cells may increase if blood loss was above of 800 ml and surgical duration more than 300 minutes. The duration of orthognathic surgery may have a significant effect on blood loss and blood transfusions. It seems subjects with positive blood types may have a lower risk for transfusion.


Keywords


Blood transfusion; Blood products; Orthognathic surgery; Osteotomy

Full Text:

PDF

References


Shander A, Fink A, Javidroozi M, Erhard J, Farmer SL, Corwin H, et al. Appropriateness of allogeneic red blood cell transfusion: the international consensus conference on transfusion outcomes. Transfus Med Rev. 2011; 25(3): 232-46.

Glance LG, Dick AW, Mukamel DB, Fleming FJ, Zollo RA, Wissler R, et al. Association between intraoperative blood transfusion and mortality and morbidity in patients undergoing noncardiac surgery. Anesthesiology. 2011; 114(2): 283-92.

Marik PE, Corwin HL. Efficacy of red blood cell transfusion in the critically ill: a systematic review of the literature. Crit Care Med. 2008; 36(9): 2667-74.

Marciani RD, Dickson LG. Autologous transfusion in orthognathic surgery. J Oral Maxillofac Surg. 1985; 43(3): 201-4.

Metz J, McGrath KM, Copperchini ML, Haeusler M, Haysom HE, Gibson PR, et al. Appropriateness of transfusions of red cells, platelets and fresh frozen plasma. An audit in a tertiary care teaching hospital. Med J Aust. 1995; 162(11): 572-7.

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

Messmer K. Hemodilution--possibilities and safety aspects. Acta Anaesthesiol Scand Suppl. 1988; 89: 49-53.

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.

Flood TR, Ilankovan V, Moos KF, el-Attar A. Cross-match requirements in orthognathic surgery: an audit. Br J Oral Maxillofac Surg. 1990; 28(5): 292-4.

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, Marukawa K, Shimada M, Nakagawa K, Yamamoto E. The assessment of blood loss in orthognathic surgery for prognathia. J Oral Maxillofac Surg. 2005; 63(3): 350-4.

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.

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.

Ash DC, Mercuri LG. The relationship between blood ordered and blood administered in orthognathic surgery: a retrospective study. J Oral Maxillofac Surg. 1985; 43(12): 944-6.

Rummasak D, Apipan B, Kaewpradup P. Factors that determine intraoperative blood loss in bimaxillary osteotomies and the need for preoperative blood preparation. J Oral Maxillofac Surg. 2011; 69(11): e456-e460.

Faverani LP, Ramalho-Ferreira G, Fabris AL, Polo TO, Poli GH, Pastori CM, et al. Intraoperative blood loss and blood transfusion requirements in patients undergoing orthognathic surgery. Oral Maxillofac Surg. 2014; 18(3): 305-10.

Goodnough LT, Brecher ME, Kanter MH, AuBuchon JP. Transfusion medicine. First of two parts--blood transfusion. N Engl J Med. 1999; 340(6): 438-47.

Garg M, Coleman M, Dhariwal DK. Are blood investigations, or group and save, required before orthognathic surgery? Br J Oral Maxillofac Surg. 2012; 50(7): 611-3.

Chen CM, Lai SS, Hsu KJ, Lee HE, Huang HL. Assessment of the related factors of blood loss and blood ingredients among patients under hypotensive anesthesia in orthognathic surgery. J Craniofac Surg. 2011; 22(5): 1594-7.

Fenner M, Kessler P, Holst S, Nkenke E, Neukam FW, Holst AI. Blood transfusion in bimaxillary orthognathic operations: need for testing of type and screen. Br J Oral Maxillofac Surg. 2009; 47(8): 612-5.

Pineiro-Aguilar A, Somoza-Martin M, Gandara-Rey JM, Garcia-Garcia A. Blood loss in orthognathic surgery: a systematic review. J Oral Maxillofac Surg. 2011; 69(3): 885-92.

Posnick JC, Rabinovich A, Richardson DT. Blood replacement practices for complex orthognathic surgery: a single surgeon's experience. J Oral Maxillofac Surg. 2010; 68(1): 54-9.


Refbacks

  • 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.