Blood loss and transfusion requirements in orthognatic surgery

J Oral Maxillofac Surg. 1996 Jan;54(1):21-4; discussion 25-6. doi: 10.1016/s0278-2391(96)90295-5.

Abstract

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.

MeSH terms

  • Adolescent
  • Adult
  • Blood Loss, Surgical*
  • Blood Transfusion*
  • Blood Volume Determination
  • Child
  • Female
  • Humans
  • Male
  • Middle Aged
  • Orthognathic Surgical Procedures*
  • Osteotomy / adverse effects*
  • Retrospective Studies