Blood loss and transfusion in head and neck tumour surgery

Major head and neck surgical procedures at the Department of Otolaryngology, Singapore General Hospital during a two year period were reviewed. Sixty-three patients were available for study. Data obtained included tumour site and stage, surgical procedure, duration of operation, preoperative haemoglobin and haematocrit, estimated surgical blood loss, amount of blood ordered and used. Data were grouped by procedure. Temporal bone resections showed the highest average estimate of blood loss (1203 mL) and the highest average blood use (3.0 units), followed by composite resections (1067 mL and 2.3 units) and maxillectomy/midface procedures (616 mL and 1.4 units). The degree of blood loss showed a positive correlation with the duration of operative procedure. The majority of patients (62%) met all criteria to qualify as autologous blood donors making autologous transfusion a feasible option for these patients.