Demand and use of blood transfusions for elective surgical operations

In elective surgical operations on thyroid gland and breast gland, in cholecystectomy, axillary or inguinal dissections and hernioplasties blood units are usually ordered for the operation. The aim of the study was to analyse the real requirement of transfusions during several years and to show that in the above-mentioned operations only in exceptional cases blood units must stand by. Methods: At the Surgical Hospital I of the University Leipzig, a retrospective analysis of the anaesthetic records and patient documentations from 1994 to 1997 was performed with regard to intraoperative blood transfusions. Results: There were 1122 operations on the thyroid gland (119 of it as total thyroidectomy), 465 operations on the breast gland, 413 cholecystectomies, 70 axillary and 60 inguinal dissections and 445 hernioplasties. Intraoperative transfusions were necessary in nine operations on the thyroid gland (0.8 %), in six operations on the breast gland 1.3 %), twice in cholecystectomy (0.5 %) and only once in an axillary dissection (1.4 %). The analysis of the patients' records showed in almost all of these cases special risk factors such as disorders of blood coagulation or thyroidal function, anaemia, serious other diseases or a necessary extension of the operation. Conclusion: It is justified to perform the above-mentioned operations without a routine order of blood units. This would lead to enormous financial savings. Because the optimal care for the patients has priority, it is necessary to estimate the individual risk of a required transfusion preoperatively and to keep low the blood loss by the surgeon during the operation.