Introduction: The effect of burns surgery that requires intraoperative
transfusion of five or more units of blood on serum vancomycin levels
was assessed. Methods: Serum vancomycin levels were measured 10 min a
nd 6 h after vancomycin administration with surgery being performed in
the interval. The following day the same dose of vancomycin was given
and serum vancomycin levels measured at the same times without interv
ening surgery. Results: Thirteen operations involving nine patients wh
o required a mean blood transfusion of 9.2 units were studied. There w
as very little difference between 10-min levels, 6-h levels and the ch
ange over interval (absolute and percentage) on the day of surgery and
the following day. The recorded serum levels were often at the lower
end of the desired range, especially in patients who underwent the lar
ger operations. This was the case on both day of surgery and the contr
ol day. Conclusions: Large volume blood loss and replacement during bu
rns surgery did not significantly affect perioperative vancomycin leve
ls. (C) 1998 Elsevier Science Ltd for ISBI. All rights reserved.