Blood loss and transfusion requirements in orthognatic surgery.
OBJECTIVE
This study quantified the blood loss and transfusion requirements in orthognathic surgery.


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.
Department of Oral and Maxillofacial Surgery, University of Hong Kong, Hong Kong.
N
N
Samman
L K
LK
Cheung
A C
AC
Tong
H
H
Tideman
D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D001811:Blood Volume Determination; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056948:Orthognathic Surgical Procedures; D010027:Osteotomy / Q000009:adverse effects*; D012189:Retrospective Studies