BLOOD-LOSS AND TRANSFUSION REQUIREMENTS IN ORTHOGNATHIC SURGERY

Purpose: This study quantified the blood loss and transfusion requirem ents in orthognathic surgery. Patients and Methods: Three hundred sixt y consecutive healthy orthognathic surgery patients were included in t his retrospective study. The female:male ratio was 1.8:1, and the age range was 8 to 49 years (mean, 24). Estimated blood volume (EBV), esti mated blood loss (EEL), and transfused blood were calculated. Results: EEL ranged from 50 to 5,000 mL (mean, 600) representing up to 73% of EBV (mean, 16%). In total, 24% (84 patients) were transfused, 8.7% (6 patients) after single-jaw surgery and iliac bone harvest and 26.7% (7 8 patients) after bimaxillary osteotomies. Forty-seven patients receiv ed 1 unit of transfused blood, 25 patients had 2 units, and 12 patient s had more than 2 units. Most transfused patients lost 11% to 40% of E BV. Conclusions: Transfusion is not necessary for single-jaw surgery u nless a bicoronal flap or iliac bone harvest are required. Although on ly 27% of bimaxillary osteotomy patients required transfusion of 1 to 2 units, this group was not predictable based on the type of procedure involved, and a further subgroup (4% of the 291 patients) required a larger transfusion.