title: Predictors of blood transfusion in deep inferior epigastric artery perforator flap breast reconstruction.
abstract: Perioperative blood loss during and following breast reconstruction surgery can have substantial impact on free flap survival and patient morbidity. Transfusion rates of up to 95% have been reported following transverse rectus abdominis myocutaneous flap breast reconstruction, with blood loss described as significant in most cases. However, there has been little reported of such requirements in patients undergoing deep inferior epigastric perforator (DIEP) flap breast reconstruction. We present the transfusion requirements of 152 consecutive patients who underwent DIEP flap breast reconstruction, with a view to quantifying transfusion requirements and identifying risk factors for such loss. In this cohort, 80.3% of patients required blood transfusion, with a mean volume of 3.9 U per patient. There was a statistically significant correlation for increased transfusion requirement in patients with preoperative anemia ( P < 0.001) and in bilateral cases ( P < 0.001), but not for cases of immediate reconstruction ( P = 0.72). Although blood loss in breast reconstructive surgery is rarely large enough to be life-threatening, relative anemia does have significant effect on flap survival and patient morbidity. With risk factors for increased transfusion requirements identified in the current study, high-risk patients can be predicted preoperatively.
authors: Department of Anatomy and Cell Biology, Jack Brockhoff Reconstructive Plastic Surgery Research Unit, The University of Melbourne, Victoria, Australia.
authors: Jeannette
authors: J
authors: Ting
authors: Warren M
authors: WM
authors: Rozen
authors: Cara Michelle
authors: CM
authors: Le Roux
authors: Mark W
authors: MW
authors: Ashton
authors: Emilio
authors: E
authors: Garcia-Tutor
mesh_terms: D016063:Blood Loss, Surgical; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000469:parasitology / Q000601:surgery*; D019074:Epigastric Arteries / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006801:Humans; D015994:Incidence; D008408:Mastectomy / Q000379:methods; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D017568:Rectus Abdominis / Q000098:blood supply / Q000637:transplantation*; D018570:Risk Assessment; D013524:Surgical Flaps / Q000009:adverse effects / Q000098:blood supply*; D014182:Transplantation, Autologous; D016896:Treatment Outcome