2009 Volume 19 Issue 3 Pages 145-149
Blood transfusion is occasionally needed in orthognathic surgery. In our department, to avoid allogenic transfusions and, to obtain autofibrin glue which promotes intraoperative primary hemostasis, we collected blood for autologous blood donation (ABD) during unilateral surgeries such as sagittal split ramus osteotomy (SSRO). We conducted a retrospective survey of the SSRO in our department and investigated the efficacy of ABD. Furthermore, we investigated the factors that could predict those patients whose recovery from anemia would be delayed, before phlebotomy.
We investigated the patients who required preoperative ABD before independent SSRO. Within 24 hours following the surgery, the blood was transfused. To investigate the postoperative influence of the preoperative autologous blood collection, we divided the subjects into a recovered group in whom Hb value on day 7 after the surgery was less than 5% of the value prior to ABD, and all other subjects into the non-recovered group. Moreover, we investigated whether our results contained any factors that could predict these non-recovered patients prior to surgery. Significance was established at p < 0.05.
There were 4 cases in which bleeding in excess of 20% of the predicted blood circulation was observed. Although there was no significant difference between the Hb value prior to autologous blood collection, the non-recovered group showed a higher value than the recovered group. The lowest Hb value for both groups occurred on day 4 after the surgery, irrespective of whether an ABD was performed. We predicted that, if the blood was not transfused, the Hb value at this period might be further decreased. Even in cases where allogenic transfusions were considered because of the degree of bleeding, we believe that preoperative ABD during SSRO is advantageous.
This investigation suggests that it is possible to use the patient's weight and Hb value prior to blood collection for predicting the patient's inclusion in the non-recovered group.
We investigated the efficacy of preoperative ABD during orthognathic surgery. In almost all cases, we believe that no indication for allogenic transfusions was present. However, we believe that preoperative ABD, with primary hemostasis using fibrin glue and avoiding allogenic transfusion that can cause unpredictable significant blood loss, is the preferred method of transfusion.
