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Blood loss and transfusion requirements in orthognatic surgery
N Samman1, L K Cheung, A C Tong
1Department of Oral and Maxillofacial Surgery, University of Hong Kong, Hong Kong.
Purpose:
This study quantified the blood loss and transfusion requirements in orthognathic surgery.
Patients And Methods:
Three hundred sixty consecutive healthy orthognathic surgery patients were included in this retrospective study. The female:male ratio was 1.8:1, and the age range was 8 to 49 years (mean, 24). Estimated blood volume (EBV), estimated blood loss (EBL), and transfused blood were calculated.
Results:
EBL ranged from 50 to 5,000 mL (mean, 600) representing up to 73% of EBV (mean, 16%). In total, 24% (84 patients) were transfused, 8.7% (6 patients) after single-jaw surgery and iliac bone harvest and 26.7% (78 patients) after bimaxillary osteotomies. Forty-seven patients received 1 unit of transfused blood, 25 patients had 2 units, and 12 patients had more than 2 units. Most transfused patients lost 11% to 40% of EBV.
Conclusions:
Transfusion is not necessary for single-jaw surgery unless a bicoronal flap or iliac bone harvest are required. Although only 27% of bimaxillary osteotomy patients required transfusion of 1 to 2 units, this group was not predictable based on the type of procedure involved, and a further subgroup (4% of the 291 patients) required a larger transfusion.