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

Al-Sebaei, Maisa O

doi:10.1186/s13037-014-0041-6

Cited by 22 publications

(14 citation statements)

References 28 publications

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“…In orthognathic surgery, RBC transfusions are relatively infrequent with a reported incidence rate of 2-19.5% 5 , 23 , 25 . In the present study, 49 (16.3%) patients received RBC transfusions.…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported in previous studies that EBL, operative time 15 , 23 , adjunctive surgical procedures 26 , 27 , gender, and experience of the surgeon 28 are factors that influence RBC transfusion during orthognathic surgeries. In the present study, the operating time and EBL also exhibited significant differences between the TF and NTF groups.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the mean value of pulmonary compliance, peak inspiratory pressure, and BIS were collected every 15 minutes. The EBL was calculated by subtracting the volume of saline solution used for irrigation from the total volume accumulated in the suction unit 23 , 24 . The blood in the gauze was not included in the EBL measurement.…”

Section: Methodsmentioning

confidence: 99%

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Predictors of Red Blood Cell Transfusion in Bimaxillary Orthognathic Surgery: A Retrospective Study

Rhee

Seo

et al. 2021

Int. J. Med. Sci.

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Background: Orthognathic surgery requires red blood cell (RBC) transfusions more frequently than other oral and maxillofacial surgeries. The purpose of this study was to identify reliable predictors for RBC transfusion during bimaxillary orthognathic surgery (BOS). Methods: This retrospective study reviewed 1,616 electronic medical records of patients who underwent BOS during a 5-year period at Seoul National University Dental Hospital. The perioperative variable data were collected from electronic medical records and analyzed by dividing patients into the two groups (non-transfusion and transfusion group). Results: Of the 1,616 patients, 1,311 patients were excluded. The remaining 305 patients were divided into non-transfusion (NTF, n = 256) and transfusion (TF, n = 49) groups. Univariate logistic regression analysis revealed that age, body mass index, the presence of several adjunctive surgeries (including genioplasty, extraction, and mandibular angle reduction), preoperative hemoglobin (Hb) and prothrombin time, surgical time, amount of fluid infusion and blood loss, and mean pulse rate during surgery were significant factors predicting RBC transfusion. Multivariate logistic regression analysis revealed that preoperative Hb and blood loss amount during surgery were significantly related to RBC transfusion in BOS patients. Conclusion: Since blood loss amounts could not be measured preoperatively, we found that the independent predictor associated with RBC transfusion during BOS was a low preoperative Hb level.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Predictors of Red Blood Cell Transfusion in Bimaxillary Orthognathic Surgery: A Retrospective Study

Rhee

Seo

et al. 2021

Int. J. Med. Sci.

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“…For this reason, clinicians have made efforts to reduce intraoperative bleeding in OGS. Previous studies have revealed several factors that can reduce blood loss during OGS, including the duration of surgery, type of surgical procedure, proficiency of the surgeon, and type of anesthesia 2 17 18 19 20 21 22 . Additionally, in 1999, Rohling et al 23 reported that methods for reducing intraoperative bleeding during OGS included the use of an atraumatic surgical approach, moderate hypotension control, and placement of the surgical site above the heart.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative blood loss and surgical time according to the direction of maxillary movement

Kim¹,

Son²,

Chung³

et al. 2020

Arch Plast Surg

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Background Excessive bleeding is one of the most severe complications of orthognathic surgery (OGS). This study investigated the associations of intraoperative blood loss and surgical time with the direction of maxillary movement.Methods This retrospective study involved patients who underwent OGS from October 2017 to February 2020. They were classified based on whether maxillary setback was performed into groups A1 and B1, respectively. Relative blood loss (RBL, %) was used as an indicator to compare intraoperative blood loss between the two groups. The surgical time of the two groups was also measured. Subsequently, the patients were reclassified based on whether posterior impaction of the maxilla was performed into groups A2 and B2, respectively. RBL and surgical time were measured in the two groups. Simple linear and multiple regression analyses were performed. P-values <0.05 were considered to indicate statistical significance.Results Eighteen patients were included. The RBL and surgical time for the groups were: A1, 13.15%±5.99% and 194.37±42.04 minutes; B1, 12.41%±1.89% and 196.50±46.07 minutes; A2, 13.94%±3.82% and 201.00±39.70 minutes; and B2, 9.61%±3.27% and 188.84±38.63 minutes, respectively. Only RBL showed a statistically significant difference between the two groups (A2 and B2, P=0.04).Conclusions Unlike maxillary setback, posterior impaction of the maxilla showed a significant association with RBL during surgery. When performing posterior impaction of the maxilla, clinicians need to pay particular attention to surgery and postoperative care.

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“…Although there are guidelines on blood transfusion, however to date, evidence from the literature still suggests blood transfusion practice to be heterogeneous with large variation among clinicians, units, and hospitals. [ 8 18 19 ] Previous studies have described the pattern of blood transfusion in hospital-wide settings as well as use in specific procedures; however, no previous study has looked at a clinically appropriate pattern of blood transfusion during the surgical management of noma defects. For surgical repair of noma defects, cutting down on unnecessary ordering of blood and unnecessary transfusion can make this scarce product more available when needed; it will also help to reduce the risk of infection associated with transfusion, reduce expenses in an already resource-scarce setting, as well as reduce the time lost in waiting for surgery.…”

Section: Introductionmentioning

confidence: 99%

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

Bala

Gbolahan

Taiwo

et al. 2022

Journal of West African College of Surgeons

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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.

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

Cited by 22 publications

References 28 publications

Predictors of Red Blood Cell Transfusion in Bimaxillary Orthognathic Surgery: A Retrospective Study

Predictors of Red Blood Cell Transfusion in Bimaxillary Orthognathic Surgery: A Retrospective Study

Intraoperative blood loss and surgical time according to the direction of maxillary movement

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

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