Determination of blood loss in bimaxillary surgery: does the formula and the time point affect results?

Schwaiger, Michael; Edmondson, Sarah‐Jayne; Merkl, M.; Tse, Gary; Zemann, Wolfgang; Wallner, Jürgen

doi:10.1016/j.ijom.2021.08.006

Cited by 1 publication

(1 citation statement)

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“…This is thought to be due in part to bleeding into tissue spaces, such as the maxillary sinuses, which is therefore not accounted for [6]. Regarding the perioperative blood loss, the formula used to calculate blood loss in conjunction with the timepoint chosen has been shown to strongly influence the bleeding volumes determined [57]. While we acknowledge these potential shortcomings, it has previously been shown by our group that the formula applied does not significantly alter results, when measuring blood loss 48 h after surgery, where normalised blood levels are to be assumed.…”

Section: Gender-related Differences In the Haemostatic Profilementioning

confidence: 99%

Gender-specific differences in haemostatic parameters and their influence on blood loss in bimaxillary surgery

et al. 2022

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Objective The objectives of this prospective cohort study were to establish gender-related differences in blood loss and haemostatic profiles associated with bimaxillary surgery. In addition, we aimed to identify if any gender differences could be established which might help predict blood loss volume. Materials and methods Fifty-four patients (22 males; 32 females) undergoing bimaxillary surgery for skeletal dentofacial deformities were eligible for inclusion. Blood samples were taken 1 day preoperatively and 48 h postoperatively for detailed gender-specific coagulation analysis incorporating global coagulation assays (endogenous thrombin potential) and specific coagulation parameters. Blood loss was measured at two different time points: (1) the end of surgery, visible intraoperative blood loss (IOB) using ‘subtraction method’; and (2) 48 h postoperatively perioperative bleeding volume (CBL-48 h) using ‘haemoglobin-balance method’ and Nadler’s formula. Correlation and regression analyses were performed to identify relevant parameters affecting the amount of blood loss. Results Significant differences in IOB and CBL-48 h were observed (p < 0.001). Men had higher IOB versus women, lacking statistical significance (p = 0.056). In contrast, men had significantly higher CLB-48 h (p = 0.019). Reduced CBL-48 h was shown to be most closely associated with the level of Antithrombin-III being decreased in females. Conclusions Male gender is associated with higher IOB and CBL-48 compared with females. Gender does not affect IOB regarding haemostatic profile but does correlate strongly with procedure length. Conversely, CBL-48 is closely associated with gender-specific imbalances in the anticoagulant system. Clinical relevance Knowledge of gender-related differences will help clinicians establish predictive factors regarding excessive blood loss in orthognathic surgery and identify at-risk patients.

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Section: Gender-related Differences In the Haemostatic Profilementioning

confidence: 99%