Blood crossmatching for burn surgery: potential for reduced wastage using a modified Dye formula

Estimating the perioperative crossmatch requirement (CMR) of burn patients is difficult, as losses are variable and hard to predict. Accuracy is impor tant, however, as over-provision risks wasting blood. Blood ordering tariff s have increased efficiency and reduced blood wastage in other branches of surgery. Dye has published a tariff for burn patients in the form of a form ula, relating CMR to weight and percentage total body surface area (TBSA) e xcised. This study examines the efficiency of blood ordering and use among 72 burn patients and compares outcomes with the predictions of Dye's and a modified Dye's formula, for the same patients. All patients were crossmatch ed, but only 34 patients were transfused. The crossmatch:transfusion ratio was 2.1, with 52% of crossmatched blood being unused. Dye's formula would h ave reduced the total volume crossmatched for the same patients by 13%. The crossmatch:transfusion ratio would be 1.8, with 44% of cross-matched blood remaining unused. A modified form of Dye's formula was designed to reduce the high rate of blood non-use. This would reduce the total Volume crossmat ched by 40% and the rate of blood non-use to 20%. The crossmatch:transfusio n ratio would be 1.24. (C) 1999 Elsevier Science Ltd and ISBI. All rights r eserved.