Routine predeposit of autologous blood is not warranted before breast reduction surgery

To assess perioperative blood losses and transfusion requirements in patients who undergo breast reduction surgery and to gauge the impact of an autologous blood program on homologous transfusion requirements.

A chart review of patients who underwent breast reduction surgery between 1988 and 1992.

The Ottawa General Hospital, a teaching hospital with a surgical training program but with no plastic surgery program.

Included in the review were all 153 patients who had breast reduction surgery during the study period. Twenty patients were excluded because either the predonation or the final hemoglobin concentration was not available. The remaining 133 patients were divided into three groups: group 1--patients who had not predonated blood (63); group 2--patients who predonated blood and received a transfusion (55); and group 3--patients who had predonated blood but did not receive a transfusion (15).

The mean final hemoglobin concentrations, the number of patients who lost more than 30 g/L of hemoglobin and the requirements for homologous transfusions.

The rate of homologous transfusion was 1% whether the patients had predonated blood or not. If a more restricted pattern of transfusion been used this rate would have been lower. The final hemoglobin concentration was similar in all three groups. More patients in group 3 (60%) lost more than 30 g/L of hemoglobin compared with the initial hemoglobin value than either group 1 (23%) or group 2 (20%) (p < 0.01).

The routine inclusion in autologous blood programs of patients scheduled to undergo breast reduction surgery is not warranted.