MAXILLOFACIAL SURGERY
TRANSFUSION NEED IN ORTHOGNATHIC SURGERY - A REVIEW
Constantinus Politis 1a* , Ivo Lambrichts 2b , Jimoh Olubanwo Agbaje 1c
OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium and
Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, BE-3000 Leuven, Belgium
2
Faculty of Medicine, Hasselt University, Diepenbeek, Belgium; Biomedical Research Institute, Laboratory of Morphology, Hasselt University, Campus
Diepenbeek, BE-3590 Diepenbeek, Belgium
1
MD, DDS, MHA, MM, PhD, Professor
DDS, PhD, Professor
c
BDS, DMD, FMCDS, MMI, PhD
a
b
Received : April 03, 2017
Revised: May 05, 2017
Accepted: August 14, 2017
Published: August 16, 2017
Academic Editor: Nardi Casap-Caspi, DMD, MD, PhD, Professor and Head, Hebrew University Hadassah Jerusalem, Jerusalem, Israel
Cite this article:
Politis C, Lambrichts I, Agbaje JO. Transfusion need in orthognathic surgery - a review. Stoma Edu J. 2017;4(3):184-199.
Abstract
DOI: 10.25241/stomaeduj.2017.4(3).art.4
Background: Excessive blood loss is the most frequently encountered perioperative problem in
maxillary surgery, sometimes necessitating blood transfusion.
Objective: The aim of the present contribution is to review the relationship between different types
of orthognathic procedures and the related blood loss in the literature published between 1976 and 2012.
Data Sources: The orthognathic literature was searched from 1976 to 2012 to determine the
relationship between different types of orthognathic procedures and the related blood loss, duration
of surgery and/or transfusion need.
Study Selection: articles containing clear information on allocation of operation time AND/OR blood
loss AND/OR transfusion were included.
Data Extraction: information on operation time, blood loss, transfusion, and orthognathic surgery
was extracted.
Data Synthesis: Different descriptions of procedures and techniques are grouped together in a
concise and coherent way, this result in number of categories per label, using this grouping various
targeted questions are exploited and answered.
Keywords: orthognathic surgery, blood loss, operation time, blood transfusion.
1. Introduction
Excessive blood loss is the most frequently
encountered perioperative problem in maxillary
surgery, sometimes necessitating blood transfusion
according to Mahy et al. 1
Blood transfusion in itself can lead to complications,
such as the transmission of disease or graft-versus-
host reactions.
Piñeiro-Aguilar et al. (2011), 2 in a recent systematic
review, concluded that intraoperative bleeding
observed in patients undergoing Le Fort I
and mandibular ramus osteotomies, alone or
combined, has generally been less than the limits
set to determine the need for a blood transfusion
(indicated in healthy adults when hemoglobin is
less than 7 g/dL). However, they state bleeding can
sometimes reach or surpass the threshold limits
for a blood transfusion, and this event should be
anticipated by reserving blood at a blood bank or
by preparing an autotransfusion. Piñeiro-Aguilar et
al’s paper was criticised by Dodson (2011) 3 because
there was no clear, clinically directed, specific
clinical question or challenge to address, resulting
in clinically uninformative results. Also, the review
of Piñeiro-Aguilar et al. (2011) 2 failed to differentiate
among the different orthognathic procedures, and
all procedures (single-jaw Bilateral Sagittal Split
Osteotomy (BSSO), single-jaw Le Fort I, bimaxillary
procedures) were treated in the study as a single
entity.
The aim of the present contribution is to review the
relationship between different types of orthognathic
procedures and the related blood loss in the literature
published between 1976 and 2012.
2. Methods
2.1. Literature review: selection criteria
The following entries: Blood loss and orthognathic,
Transfusion and orthognathic, Hypotension and
orthognathic and Blood transfusion and orthognathic
surgery that were introduced in PubMed, Scopus
and LIMO.
No limits were set for language, year, field. A
manual search for articles containing information
on operation time, blood loss, transfusion, and
orthognathic surgery was performed in the following
journals until 1976:
- British Journal of Oral and Maxillofacial Surgery
*Corresponding author:
Professor Constantinus Politis, MD, DDS, MHA, MM, PhD, Department of Oral & Maxillofacial Surgery, University Hospitals of Leuven, Kapucijnenvoer 33, BE-3000 Leuven, Belgium
Phone: +32 (0) 16.341780, Fax: +32 (0) 16 3 32437, e-mail: [email protected]
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Stoma Edu J. 2017;4(3): 184-199
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