Blood Replacement Practices for Complex Orthognathic Surgery: A Single Surgeon's Experience

Purpose: The purpose of this study is to review the blood replacement practices in a consecutive series of a single surgeon's experience whose patients all underwent, at a minimum, simultaneous Le Fort I maxillary osteotomy, bilateral sagittal split osteotomies of the mandible, septoplasty, and inferior turbinate reduction procedures. Patients and Methods: A consecutive series of a single surgeon's patients who met inclusion criteria of (n = 34) during a 5-month time frame were included. Records included office charts, hospital records, and data stored at the Red Cross (hospital) blood bank. Results: A total of 76% (26/24) of the study patients chose to auto donate. Only 2 of the study patients underwent blood transfusion (6%). One of the transfused patients received 1 unit of auto-donated blood, whereas the other transfused patient received a unit of homologous packed red blood cells. Based on the total units of blood predonated, 97% (28/29) of stored units were discarded. Conclusion: Only a small percentage (6%) of individuals undergoing complex orthognathic and intranasal surgery received blood replacement. We believe that close collaboration between the surgical and anesthesia teams and the recovery of patients in a safely monitored environment will continue to reduce the need for transfusion in the orthognathic patient. (C) 2010 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 68:54-59, 2010