Blood loss in major lipoplasty procedures with the tumescent technique

Intraoperative blood loss and postoperative anemia have been a concern when more than 1500 ml of lipoplasty material is aspirated. Blood loss is minimal when the targeted area is infiltrated with large volumes of dilute lidocaine and epinephrine. However, little quantitative data are available regarding the intraoperative blood loss and postoperative hemoglobin drop.

In this prospective study 38 consecutive women were investigated with preoperative measurement of hemoglobin, platelet count, prothrombin time, activated partial thromboplastin time, and postoperative measurement of hemoglobin. Hemoglobin and whole blood volume were calculated from the infranatant portion of the lipoplasty aspirate. All procedures were done with the patient under general anesthesia.

The mean (+/-SD) volume of lipoplasty aspirate material was 2900+/-14702.8 ml (range 1000 to 5800 ml). The mean (+/-SD) whole blood volume in lipoplasty aspirate per case was 36+/-50.82 ml (range 1.2 to 251 ml). The mean (+/-SD) fall in hemoglobin was 0.93+/-0.92 gm/dl (range 0.2 to 4.3 gm/dl). The volume of whole blood loss was estimated to be 12.4 ml in each 1000 ml of lipoplasty aspirate. No blood transfusions were required.

Data show that blood loss with the tumescent technique is remarkably low. Use of this technique permits large-volume lipoplasty aspirate and minimizes the need for blood transfusion.