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Predicting blood loss in burn excisional surgery.

Rolf K Gigengack1, Diman Taha2, T Martijn Kuijper3

  • 1Departments of Trauma and Burn surgery, Maasstad Hospital, Rotterdam, the Netherlands; Amsterdam UMC location Vrije Universiteit, Amsterdam, Department of Intensive Care, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam UMC location Vrije Universiteit, Amsterdam, Department of Anesthesiology, De Boelelaan 1117, Amsterdam, the Netherlands.

Burns : Journal of the International Society for Burn Injuries
|February 2, 2023
PubMed
Summary

This study developed a model to predict significant blood loss during burn surgery for small burns (≤10% BSA). The model accurately identifies patients at risk, aiding in better surgical planning and patient care.

Keywords:
Blood lossBurn excisional surgeryPrediction model

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Area of Science:

  • Medical Science
  • Surgical Oncology
  • Burn Care

Background:

  • Blood loss in burn excisional surgery impacts patient outcomes.
  • Research on blood loss in small burns (≤10% body surface area) is limited.
  • Identifying patients at risk for significant blood loss is crucial.

Purpose of the Study:

  • To investigate blood loss during burn excisional surgery for burns ≤10% BSA.
  • To develop a prediction model for identifying patients at risk of significant blood loss (>250 ml).

Main Methods:

  • Retrospective study of adult patients undergoing burn excisional surgery ≤10% BSA (2013-2018).
  • Multivariable logistic regression used to build a prediction model for blood loss >250 ml.
  • Model performance assessed using Area Under the ROC Curve (AUC) and calibration.

Main Results:

  • Median blood loss was 50 ml/% BSA excised or 0.28 ml/cm² excised.
  • 39% of patients experienced blood loss >250 ml.
  • The prediction model achieved an AUC of 0.922, based on excision size, surgery length, and ASA score.

Conclusions:

  • A significant portion of patients with small burns are at risk for higher blood loss.
  • The developed prediction model accurately identifies patients at risk for significant blood loss (>250 ml).
  • This model can aid in surgical planning and patient management for burn excisional surgery.