Intraoperative blood loss in bimaxillary orthognathic surgery with multisegmental Le Fort I osteotomies and additional procedures

Kretschmer, W.; Băciuț, Grigore; Bacuit, Mihaela; Zoder, Werner; Wangerin, K.

doi:10.1016/j.bjoms.2009.07.011

Cited by 40 publications

(13 citation statements)

References 19 publications

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“…The predictors of intraoperative blood loss during orthognathic procedures also vary in the literature. Some authors have reported correlations with gender [ 1 ], operative time [ 1 , 12 ] and surgeon experience [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…Autogenous blood is considered safer and to reduce the risk of transfusion complications [ 25 ]; however, many recent studies have not recommended the use of autologous blood donation as a routine part of orthognathic surgical procedures [ 7 , 12 , 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…These patients had the physiologic reserves to compensate for the blood loss provided that their HGB level was 7–8 and that they were asymptomatic [ 6 ]. Few isolated cases of orthognathic procedures are considered to be life-threatening [ 30 ], and many of these have pre-existing coagulopathies that justify the ordering of a cross-match or auto-donation [ 12 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

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Predictors of intra-operative blood loss and blood transfusion in orthognathic surgery: a retrospective cohort study in 92 patients

Al-Sebaei

2014

Patient Saf Surg

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BackgroundPatients undergoing orthognathic procedures can require blood transfusions. The objectives of this study were to evaluate the predictors of intra-operative blood loss in patients undergoing orthognathic procedures and the transfusion rates and practices of our institution.Materials and methodsThis retrospective study included 92 patients who underwent the following four types of orthognathic procedures: Group 1, bimaxillary; Group 2, bimaxillary with bone grafts; Group 3, LeFort I osteotomies; and Group 4, LeFort I osteotomies with bone grafts. The intra-operative blood loss, operative time, age, gender and pre- and post-operative HGB and HCT were assessed.ResultsThe mean blood loss for all groups was 650 ± 397.8 mL, and there were differences in blood loss between the four groups (p = 0.211). The mean operative time was 5 hours and 32 minutes. There were no differences in intra-operative blood loss between the genders or the BMI categories. The operative time was moderately correlated with the intra-operative blood loss (p < 0.001, r =0.332). Eighteen of the 92 patients (19.5%) received blood transfusions. The mean intra-operative blood loss was higher among the patients who received transfusions (p < 0.001).ConclusionsThe only predictor of intra-operative blood loss was operative time. The observed transfusion rate was higher than those that have been reported for similar procedures; thus, our institution needs to revisit our transfusion policy and use more time-efficient techniques in the operating room.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Predictors of intra-operative blood loss and blood transfusion in orthognathic surgery: a retrospective cohort study in 92 patients

Al-Sebaei

2014

Patient Saf Surg

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“…Some authors have reported correlations with gender [1], operative time [1,12] and surgeon experience [1].…”

Section: Discussionmentioning

confidence: 99%

Predictors of intra-operative blood loss and blood transfusion in orthognathic surgery: a retrospective cohort study in 92 patients

Al-Sebaei

2014

Patient Saf Surg

View full text Add to dashboard Cite

Background: Patients undergoing orthognathic procedures can require blood transfusions. The objectives of this study were to evaluate the predictors of intra-operative blood loss in patients undergoing orthognathic procedures and the transfusion rates and practices of our institution. Materials and methods: This retrospective study included 92 patients who underwent the following four types of orthognathic procedures: Group 1, bimaxillary; Group 2, bimaxillary with bone grafts; Group 3, LeFort I osteotomies; and Group 4, LeFort I osteotomies with bone grafts. The intra-operative blood loss, operative time, age, gender and pre-and post-operative HGB and HCT were assessed.

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“…수술 이외에 추가적인 분절골절단술을 동반하여 시행하는 경우가 많아지고 있다[4][5][6][7]. 분절골절단술은 과거 Bell 등의 연구[8][9][10][11]를 통하여 알려지기 시작했으나, 수술 시간의 증가와 수술 술기의 어려움, 다양한 합병증 등으로 인해 많이 시행되지 않았다.…”

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Surgical and Orthognathic Treatment of Skeletal Class III Featuring Severe Transversal and Sagittal Discrepancy: A Case Report

Ryu¹,

Lee²,

Kim³

et al. 2013

The Journal Of Korean Association of Maxillofacial Plastic and

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Multiple segment osteotomy orthognathic surgery serves to combine the total or segmental maxillary and mandibular correction of the dentofacial deformities with concurrent procedures to provide immediate repositioning to the dento-osseous elements. In addition, splitting the palate may often be necessary to correct a functionally poor relationship of the maxilla to the mandible or the facial skeleton by realigning the maxillary arch. In this case, the discrepancy in a bimaxillary horizontal relationship and the space between the 2nd premolar and 2nd molar was retained after lengthy preoperative orthodontic treatment. However, we could correct these dento-osseous discrepancies immediately by performing midpalatal expansion, anterior segmental osteotomy and symphyseal osteotomy with bimaxillary osteotomies. If the blood supply to each segment segments was maintained and primary closure of the operation site was feasible, multiple segment osteotomy was considered as a very effective technique for treating dentofacial deformities in vertical, transverse, and sagittal dimensions with differential repositioning of all segments.

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Intraoperative blood loss in bimaxillary orthognathic surgery with multisegmental Le Fort I osteotomies and additional procedures

Cited by 40 publications

References 19 publications

Predictors of intra-operative blood loss and blood transfusion in orthognathic surgery: a retrospective cohort study in 92 patients

Predictors of intra-operative blood loss and blood transfusion in orthognathic surgery: a retrospective cohort study in 92 patients

Predictors of intra-operative blood loss and blood transfusion in orthognathic surgery: a retrospective cohort study in 92 patients

Surgical and Orthognathic Treatment of Skeletal Class III Featuring Severe Transversal and Sagittal Discrepancy: A Case Report

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