title: Hemoglobin value reduction and necessity of transfusion in bimaxillary orthognathic surgery.
abstract: OBJECTIVE
  It has been the aim of the present clinical study to assess the reduction of the hemoglobin value and the frequency of blood transfusions during bimaxillary orthognathic surgery and to discuss the clinical consequences.
  
  
  METHODS
  Fifty-six patients (31 female, 25 male; mean age, 28.6 +/- 13.0 years; range, 14 to 66 years) were operated on. Twenty-nine patients predeposited blood before surgery. As a threshold for intraoperative or postoperative transfusion, a hemoglobin value of 7.5 g/100 mL was chosen.
  
  
  RESULTS
  Perioperatively, the hemoglobin values of the patients who predeposited blood decreased significantly after blood donation. The hemoglobin value reduced postoperatively by 2.6 +/- 1.4 g/100 mL in the non-donors and by 2.6 +/- 1.1 g/mL in the donors. None of the patients who did not predeposit blood received homologous blood transfusions intraoperatively or postoperatively. In the group of patients who predeposited blood, 3 were transfused intraoperatively. They received 1 or 2 units of autologous blood.
  
  
  CONCLUSIONS
  The individual statistics of the department show that there was only a limited reduction of the intraoperative and postoperative hemoglobin values as a consequence of bimaxillary orthognathic surgery. The increased safety of homologous blood and the minimal transfusion rates support abandonment of routine predepositing of autologous blood and the acceptance of homologous blood in the rare case of transfusion in bimaxillary surgery.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany. emeka.nkenke@mkg.imed.uni-erlangen.de
authors.forename: Emeka
authors.initials: E
authors.lastname: Nkenke
authors.forename: Peter
authors.initials: P
authors.lastname: Kessler
authors.forename: Jörg
authors.initials: J
authors.lastname: Wiltfang
authors.forename: Friedrich Wilhelm
authors.initials: FW
authors.lastname: Neukam
authors.forename: Volker
authors.initials: V
authors.lastname: Weisbach
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous / Q000706:statistics & numerical data*; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D019340:Osteotomy, Le Fort; D011446:Prospective Studies; D018709:Statistics, Nonparametric
chemical_list: D006454:Hemoglobins