Intraoperative blood loss in bimaxillary orthognathic surgery with multisegmental Le Fort I osteotomies and additional procedures

• Published in: British journal of oral & maxillofacial surgery Vol. 48; no. 4; pp. 276 - 280
• Main Authors: Kretschmer, W.B, Baciut, G, Bacuit, Mihaela, Zoder, W, Wangerin, K
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.06.2010; Elsevier
• Subjects: Additional procedures; Adolescent; Adult; Age Factors; Bimaxillary osteotomies; Biological and medical sciences; Blood loss; Blood Loss, Surgical; Blood Transfusion; Bone Transplantation; Chin - surgery; Dentistry; Female; Follow-Up Studies; Hematocrit; Hemoglobins - analysis; Humans; Male; Mandible - surgery; Medical sciences; Middle Aged; Multisegmental maxillary osteotomy; Orthognathic surgery; Orthognathic Surgical Procedures - methods; Orthopedic surgery; Osteotomy - methods; Osteotomy, Le Fort - methods; Otorhinolaryngology. Stomatology; Risk Factors; Sex Factors; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Tissue and Organ Harvesting; Young Adult; Zygoma - surgery; Bimaxillary osteotomies; Orthognathic surgery; Additional procedures; Multisegmental maxillary osteotomy; Blood loss; Mandible; Treatment; Superior maxillary; Osteotomy; Stomatology; Surgery; Intraoperative
• ISSN: 0266-4356; 1532-1940
• DOI: 10.1016/j.bjoms.2009.07.011

Abstract Autologous blood donation is not currently recommended by most authors for routine bimaxillary osteotomies. There are few data about bimaxillary procedures with multisegmental maxillary osteotomies. Our aim was to investigate the effect of additional osteotomies and iliac crest grafts on operative blood loss. A total of 225 consecutive patients having bimaxillary multisegmental osteotomies during a three-year period (January 2006–January 2009) were examined to see if their haemoglobin concentration and packed cell volume were reduced. The influence of iliac crest grafts, additional osteotomies (genioplasty, malar osteotomy, iliac crest graft, anterior mandibular segmental osteotomy), operating time, age, and sex were assessed. Neither age nor sex influenced blood loss, whereas operating time correlated significantly with reductions in haemoglobin concentration and packed cell volume. Blood loss was significantly higher in the group who had additional procedures ( p 0.001 for haemoglobin concentration and packed cell volume) than in the group who had no additional procedures, whereas there were no significant differences among the three subgroups who had additional procedures (additional osteotomies, iliac crest grafts, or both procedures). Four patients who had additional procedures required transfusion, whereas no blood was given in the group who had no additional procedures. Because the transfusion rate was so low, we could make no general recommendation for preoperative blood donation in such cases.