CROSS-MATCHED BLOOD FOR MAJOR HEAD AND NECK-SURGERY - AN ANALYSIS OF REQUIREMENTS

We retrospectively analysed our blood ordering practice; the number of units of cross-matched blood requested was compared with the number t ransfused, in 70 patients undergoing a total of 82 ablative operations for malignant disease. Patients undergoing neck dissection alone, or excision of tumour with free revascularized flap reconstruction withou t neck dissection, are unlikely to require blood transfusion. Operatio ns that include excision of tumour with primary closure and neck disse ction, excision of tumour with pedicled flap reconstruction and excisi on of tumour with any form of flap reconstruction and neck dissection in continuity, will probably require transfusion. If atypical antibodi es are present in the patient's serum on screening, cross-matched bloo d should always be available preoperatively, Provided that atypical an tibodies are not present and that blood is available within 40 minutes from the blood bank, our results show that it is safe to adopt a poli cy of blood grouping and saving serum, for patients undergoing neck di ssection alone, but cross-matching two or more units of blood for pati ents who are to have more extensive operations.