Is Blood Transfusion Justified During Soft Tissue Surgery in Noma Patients? a One-Year Appraisal at Noma Children Hospital, Sokoto, Nigeria

Abstract

Background: Non-utilization of blood and inappropriate blood transfusion are common in surgical operations. Some surgical procedures are associated with minimal bleeding that does not warrant blood transfusion. No previous study has looked at the pattern of blood loss in noma defect repair to determine the possible need for blood transfusion. Aim/Objectives: This study aimed to determine the total amount of blood loss, the number of units of blood transfused, and the correlation between estimated blood loss and total operating time in patients who had surgical correction of noma defects. Materials and Methods: This is a hospital-based cross-sectional study of 35 patients who underwent surgical correction of noma defects. Age, sex, pre- and post-operative haemoglobin (Hb), number of requested blood units, total operating time, and total estimated blood loss were recorded. The methods used for the blood loss estimation were gauze swabs, Abdo-packs, drapes, and suction bottles. Results: Comparison of the mean pre- and post-operative Hb did not yield any statistically significant difference. The total estimated blood loss in these surgeries was in the range of 65–209 mL, with a mean of 117.20 ± 35.88 mL. No correlation between estimated blood loss and total operating time was noted ( P = 0.940). No blood was transfused in any of the subjects. Conclusion: This study observed minimal blood loss in surgical corrections of the soft tissue noma defect. Apart from blood grouping, there may be no need for routine cross-matching of blood pre-operatively for surgical repair of noma defect. However, more studies are needed to buttress this finding.

Surgical complications and subsequent revision surgeries among noma cases treated in Ethiopia

“…The goal of advanced surgical treatment is to restore functional abilities and aesthetic harmony, thereby improving the patient's quality of life by enabling effective speech, breathing, chewing, interaction, work, and communication 4 . In the early stage of the disease, minor surgical interventions can be employed to save lives and contain the spread of the disease 5–8 . However, complex reconstructive surgery is typically required for arrested noma.…”

“… 4 In the early stage of the disease, minor surgical interventions can be employed to save lives and contain the spread of the disease. 5 , 6 , 7 , 8 However, complex reconstructive surgery is typically required for arrested noma. Correcting deformities resulting from noma presents significant challenges for plastic and reconstructive surgeons due to the various types of disfigurement it causes in children and young adults.…”