Blood transfusion requirements in elective breast reconstruction surgery

Al-Benna, Sammy; Rajgarhia, Prachi

doi:10.1016/j.breast.2010.05.006

Cited by 13 publications

(14 citation statements)

References 8 publications

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“…However they performed 16 breast reconstructions with DIEP or TRAM‐flaps and 34 with Latissimus dorsi flaps, partial combined with an implant. Thus the transfusion rate for breast reconstruction with DIEP or TRAM‐flaps was 19% .…”

Section: Resultsmentioning

confidence: 99%

Is there a Rationale for Autologous Breast Reconstruction in Older Patients? A Retrospective Single Center Analysis of Quality of life, Complications and Comorbidities after DIEP or ms-TRAM Flap Using the BREAST-Q

et al. 2015

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Autologous breast reconstruction with the deep inferior epigastric perforator (DIEP) or muscle-sparing transverse rectus abdominis myocutaneous (ms-TRAM) flap is a common method in the majority of patients after mastectomy. Because of an increased perioperative risk profile the benefit in older patients is questionable. To assess the postoperative quality of life and peri- and post-operative complications of older compared to younger patients is the aim of this retrospective study. In a retrospective analysis 39 older (i.e. >60 years) and 140 younger patients (i.e. <60 years) with autologous breast reconstruction in the Department of Plastic Surgery at the University Hospital of Erlangen-Nuernberg were surveyed at least 6 month postoperative using the BREAST-Q questionnaire. Correlations were generated between comorbidities and complications. Significant differences were observed regarding hospitalization, pre-existing diseases and the choice of DIEP versus ms-TRAM flaps. Parameters such as major and minor complications, bulging or hernia and risk factors (e.g. smoking or obesity) showed no significant differences. The results of the questionnaire parameters showed no significant difference between both groups, revealing high satisfaction with the aesthetic result and an improvement in quality of life independent of age. Autologous breast reconstruction after mastectomy generates a gain in quality of life and shows a good to excellent overall satisfaction in older as well as younger patients. Despite a longer hospitalization and a different risk profile there were no significant differences regarding minor and major complications in the postoperative course. Hence autologous breast reconstruction for older patients is justified and should be taken into consideration.

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Section: Resultsmentioning

confidence: 99%

Is there a Rationale for Autologous Breast Reconstruction in Older Patients? A Retrospective Single Center Analysis of Quality of life, Complications and Comorbidities after DIEP or ms-TRAM Flap Using the BREAST-Q

et al. 2015

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“…We calculated the modified transfusion probability for a particular procedure by dividing the number of patients transfused by the total number of procedures . Based on previous studies, surgical procedures with a transfusion probability of <5% were considered to rarely require a blood transfusion, whereas procedures with a transfusion probability of >30% were considered to commonly require transfusion . To evaluate RBC ordering and utilization in the operating room and to improve RBC Blood Bank inventory, we calculated the crossmatch/transfusion ratio (C : T) for each procedure .…”

Section: Methodsmentioning

confidence: 99%

“…Based on previous studies, surgical procedures with a transfusion probability of <5% were considered to rarely require a blood transfusion, whereas procedures with a transfusion probability of >30% were considered to commonly require transfusion . To evaluate RBC ordering and utilization in the operating room and to improve RBC Blood Bank inventory, we calculated the crossmatch/transfusion ratio (C : T) for each procedure . A C : T ratio >2.5 indicates excessive blood product testing and availability .…”

Section: Methodsmentioning

confidence: 99%

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Pediatric preoperative blood ordering: when is a type and screen or crossmatch really needed?

Fernández

Cronin

Greenberg

et al. 2013

Pediatric Anesthesia

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“…The introduction of the Maximum Surgical Blood Order Schedule (MSBOS)-the amount of blood to be crossmatched for specific elective operations-has helped rationalize the number of units of blood routinely crossmatched for elective surgical procedures and has concomitantly reduced the unnecessary use of blood [6-8]. In our hospital, we established a MSBOS by analyzing red blood cell (RBC) utilization for elective surgeries; since then we have used the MSBOS to reserve crossmatched blood for immediate use in elective surgery.…”

Section: Introductionmentioning

confidence: 99%

Can Maximum Surgical Blood Order Schedule Be Used as a Predictor of Successful Completion of Bloodless Surgery?

Shin

2013

Ann Lab Med

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BackgroundThe Soonchunhyang University Hospital Bloodless Center was established in 2000, and more than 2,000 bloodless surgeries have been performed there since. In this study, the lowest postoperative Hb/preoperative Hb (Hblow/pre) ratio and mortality rates of patients who underwent bloodless surgery were analyzed for each maximum surgical blood order schedule (MSBOS) category to assess whether MSBOS can be used as a predictor of successful completion of bloodless surgery.MethodsA total of 971 patients were included. MSBOS was defined as the average number of units of RBCs transfused during each elective surgery. We used the Hblow/pre ratio as an alternative to intraoperative blood loss. Frequency of Hblow/pre ratios ≤0.5, use of transfusion alternatives, and mortality rates were compared across MSBOS categories.ResultsOut of the 971 patients, 701 (72.2%) were categorized as type and screen (T&S), 184 (18.9%) as MSBOS 1, 64 (6.6%) as MSBOS 2, and 22 (2.3%) as MSBOS 4. Transfusion alternatives were used by 397 (40.9%) patients. The frequency of the use of simultaneous erythropoietin and iron, hemostatics, acute normovolemic hemodilution, and Cell Saver (Haemonetics corp., USA) was higher in patients in the higher MSBOS categories. Six (0.6%) patients died within 30 days of surgery. Hblow/pre ratios tended to be lower as the level of MSBOS category increased.ConclusionsSurgeries in the higher MSBOS categories tended to be associated with high blood loss and mortality. Active use of transfusion alternatives is recommended in patients in high MSBOS categories who are scheduled to undergo bloodless surgery.

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Blood transfusion requirements in elective breast reconstruction surgery

Cited by 13 publications

References 8 publications

Is there a Rationale for Autologous Breast Reconstruction in Older Patients? A Retrospective Single Center Analysis of Quality of life, Complications and Comorbidities after DIEP or ms-TRAM Flap Using the BREAST-Q

Is there a Rationale for Autologous Breast Reconstruction in Older Patients? A Retrospective Single Center Analysis of Quality of life, Complications and Comorbidities after DIEP or ms-TRAM Flap Using the BREAST-Q

Pediatric preoperative blood ordering: when is a type and screen or crossmatch really needed?

Can Maximum Surgical Blood Order Schedule Be Used as a Predictor of Successful Completion of Bloodless Surgery?

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