Factors for Intraoperative Blood Loss in Bimaxillary Osteotomies

Kretschmer, Winfried; Köster, Ulrich; Dietz, Klaus; Zoder, Werner; Wangerin, Konrad

doi:10.1016/j.joms.2008.01.060

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 66, Issue 7 , Pages 1399-1403, July 2008

Factors for Intraoperative Blood Loss in Bimaxillary Osteotomies

Winfried Kretschmer, MD, DMD
- Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Marienhospital, Stuttgart, Germany.
- Address correspondence and reprint requests to Dr Kretschmer: Department of Oral and Maxillofacial Surgery, Marienhospital, Boeheimstraße 37, 70199 Stuttgart, Germany
Ulrich Köster, MD
- Anesthesiologist, Department of Anesthesiology and Intensive Care Medicine, Marienhospital, Stuttgart, Germany.
Klaus Dietz, PhD
- Professor and Chair, Institute of Biometry, University of Tuebingen, Germany.
Werner Zoder, MD, DMD
- Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Marienhospital, Stuttgart, Germany.
Konrad Wangerin, MD, DMD, PhD
- Professor and Head of the Department, Department of Oral and Maxillofacial Surgery, Marienhospital, Stuttgart, Germany.

Purpose

Autologous blood donation is not routinely recommended for all cases of orthognathic surgery. The aim of this study was to evaluate the factors for blood loss during bimaxillary osteotomies that might indicate preoperative blood donation.

Patients and Methods

In a prospective study, 127 consecutive patients undergoing bimaxillary surgery within a 14-month period were examined for hemoglobin and hematocrit reduction. Possible factors for intraoperative blood loss such as operating time, application of hydroxyethyl starch in segmental osteotomies, experience of the surgeon, and additional procedures (genioplasty, malar osteotomy, iliac crest graft) were statistically analyzed.

Results

The experience of the surgeon had no influence on the blood loss. Operating time and Quick value correlated significantly with hemoglobin and hematocrit drop after surgery. There was no difference between 1-piece maxilla cases with or without additional procedures and segmental maxilla cases without additional procedures. Only for the group of patients with segmental osteotomies and additional procedures was a significant higher blood loss found. Two patients (1.6%) received 1 unit of blood.

Conclusion

For patients undergoing bimaxillary osteotomies with segmentation of the maxilla and additional procedures, a preoperative donation of autologous blood should be considered.