Blood transfusions in surgery of the larynx and neck.

Abstract

Effective utilization of blood and blood products is an important consideration in elective surgical procedures. A cost-effective process will maintain availability to the general population while supplying reasonable surgical needs. Removing stored blood from the general pool strains these resources and drastically increases cost. To establish the first clinical model of study and to better predict blood requirements for elective surgery of the larynx and neck, medical records of 137 consecutive patients who underwent laryngeal surgery from January 1, 1981 to June 30, 1984 were reviewed. All patients had one or a combination of one of the following: radical neck dissection, total laryngectomy, hemilaryngectomy, and/or supra-glottic laryngectomy. Data analyzed included estimated allowable blood loss, estimated intraoperative blood loss, as well as preoperative and postoperative blood hemoglobin concentrations. Actual blood utilization was adjusted for individual patient need, and recommendations for appropriate blood screen and crossmatch were derived for each of the above surgical procedures. It was concluded that blood availability for the individual patient is best assessed by the surgeon.