Eigenblutspende in der Dysgnathiechirurgie

Abstract

Autologous blood donation should be performed from the medical point of view for double jaw surgery and considered in single cases with special risks in monomaxillary osteotomies.

Effect of induced hypotensive anaesthesia vs isovolaemic haemodilution on blood loss and transfusion requirements in orthognathic surgery: a prospective, single-blinded, randomized, controlled clinical study

“…The sex distribution and mean age were the only variables that differed ( Table 2). The difference in sex distribution probably reflects the generally greater willingness of women to seek orthognathic surgery and is in agreement with previous reports 18,20,27,30,35,42 . Since all patients were randomly assigned to the study groups, the mean age difference observed in the haemodilution group is due to stochastic distribution 34 .…”

“…2). Since, collected, but unused, blood unnecessarily decreases the haemoglobin level due to dilutional anaemia, the low risk of receiving allogenic transfusions does not justify preoperative haemodilution when using hypotensive anaesthesia in orthognathic surgery 13,18,21,41 . Induced hypotensive anaesthesia can substantially reduce intraoperative bleeding, and a further blood loss reduction can be achieved by additional blood-sparing techniques.…”

“…Surgical planning and techniques have improved to the extent that safe one-stage operations can be performed for complex bimaxillary deformities, but excessive blood loss, requiring allogenic transfusions, is one of the major complications 20,35,41 . Increasing awareness of transfusion risks have led to the development of strategies for reducing intraoperative blood loss, particularly during elective operations 6,8,10,16,18,22,33 .…”

Retrospective analysis of autologous blood use in bimaxillary repositioning osteotomy surgery: a quality improvement study

“…Because of the declining importance of preoperative autologous blood donation 11,25 and the controversial study results in the field of dysgnathic surgery, 2‐4,12 it became important to examine critically the transfusion practice at our institution. This study found a higher transfusion rate compared to other studies 3,4,9 . Furthermore, no significant decrease in transfusion frequency was seen in recent years.…”

“…Multiple studies have also shown no justification for routine preoperative autologous blood donation in bimaxillary surgery 2‐4,12 . In view of the German transfusion law and the guidelines of the Federal Medical Association, other authors recommend preoperative autologous blood donation before bimaxillary surgery 1,7,9,13 . According to paragraph 13 of the German transfusion law, a judgment of the Federal High Court (BGH, 17.12.1991–VI ZR 40/91) and the current guidelines of the Federal Medical Association, a patient must be informed of the possibility of autologous transfusion if there is a 10% or more chance of a blood loss requiring transfusion 2‐4 .…”