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Assessment of Intraoperative Blood Loss during Oral and Maxillofacial Surgical Procedures in a Nigerian Tertiary Health Care Center

DOI: 10.1155/2014/301467

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Abstract:

Background. Reports on estimated amount of blood loss in maxillofacial surgical procedures will guide clinicians through units of blood required for each procedure. The aim of the study was to assess the amount of blood loss and duration of surgery. Methods. All cases of maxillofacial surgical procedures done under GA in the MFU theatre, from January 2007 to December 2013, were included in the study. Pre- and postoperative haematocrit values, number of units of whole blood requested and used, amount of blood loss, and duration of surgery were recorded. Results. 139 patients were analyzed, of which 75 (54.0%) were males and 64 (46.0%) were females. Fifty-six (40.3%) cases involved soft tissues. Eighty-three cases involved hard tissues. Age range was 2 months to 78 years; mean ± (SD) was years. Isolated unilateral cleft lip had the lowest mean value of estimated blood loss of ?mLs and also the lowest duration of surgery of 58 (76) minutes. There was no significant relationship between both parameters for cleft lip. Fractures of the mandible had mean blood loss of 352?mLs and duration was 175?min. Conclusion. In this study, there was significant relationship between estimated blood loss and duration of surgery for mandibular and zygomatic complex fractures. 1. Introduction Intraoperative blood loss is one of the causes of death during surgical procedures [1]. Acute anaemia can also result from excessive blood loss and this can affect healing of tissues after surgery [1]. Maxillofacial surgical procedures can be classified as minor, intermediate, major, or supramajor cases based on the type and duration of the procedures [2–9]. These procedures may be associated with excessive blood loss from the facial microvasculature and major blood vessels within the operation field of the surgeon [3, 10–14]. Quite often, the lesions have also invaded the walls of the vessels [3] or lie close to these vessels, thereby making them vulnerable to injury during surgery with consequent loss of blood. Furthermore, a significant amount of bleeding can occur during dissection of the capillary-rich skin, subcutaneous tissue, and muscles in the maxillofacial region. Various strategies for preventing excessive blood loss have been applied to maintain haemostasis and these also include the use of hypotensive anaesthesia and tranexamic acid [4]. Patients may be required to donate varying number of units of blood prior to surgery which may or may not be used. The potential blood loss and estimated number of blood products required should therefore be predetermined using many factors

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