Compensation for blood loss in plastic surgery with ferastral and autologous blood transfusion

A study has been made to assess the effect on haematological status of pre-operative parenteral iron in a operation accompanied by conisderable blood loss. Forty-two patients who were to undergo breast reducing operations were selected for the trial. Patients were divided into three groups: group 1 which received no iron treatment, group 2 which received Ferastral, 250 mg Fe, 21 days before operation and group 3 which received Ferastral, 250 mg Fe, 21 days before operation plus an autologous blood transfusion during operation. The blood loss at operation which was estimated to be between 500 and 1 000 ml in 86% of the cases resulted in a decrease in haemoglobin in all groups. On the 14th postoperative day the decrease in Hb was significantly lower in both group 2 and 3 compared to group 1 (P less 0.05 and P less than 0.01, respectively). Forty per cent of the patients were anaemic in group 1, 10% in group 2 and 15% in group 3. It is concluded that the need for blood transfusion may be avoided in operations where the blood loss is less than 1 000 ml, provided sufficient iron is available for spontaneous blood replacement to take place.