Minimizing Blood Loss in Burn Surgery
- 1 December 2000
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal Of Trauma-Injury Infection and Critical Care
- Vol. 49 (6), 1034-1039
- https://doi.org/10.1097/00005373-200012000-00010
Abstract
Background Significant blood loss continues to plague early tangential excision of the burn wound. Although various techniques to reduce intraoperative blood loss have been described, there is an absence of uniformity and consistency in their application. Furthermore, it is unclear whether these techniques compromise intraoperative tissue assessment and wound outcome. The purpose of this study was to evaluate the effects of a comprehensive intraoperative blood conservation strategy on blood loss, transfusion requirements, and wound outcome in burn surgery. Methods An intraoperative blood conservation strategy (CONSV) that included donor site and burn wound adrenaline tumescence, donor site and excised wound topical adrenaline, and limb tourniquets was prospectively evaluated and compared with a historical control group (HIST) where only topical adrenaline and thrombin were applied to donor sites and excised wounds. Results Estimated blood loss was reduced from 211 ± 166 mL per percentage body surface area excised and grafted in the HIST group to 123 ± 106 mL in the CONSV group (p = 0.02). Similarly, the intraoperative transfusion requirement in the HIST group was reduced from 3.3 ± 3.1 units per case to 0.1 ± 0.3 units per case in the CONSV group (p < 0.001). There was no compromise in wound outcome in the CONSV group, which had a mean skin graft take rate of 96 ± 4.2%. Conclusion The application of a strict and comprehensive intraoperative blood conservation strategy during burn excision and grafting resulted in a profound reduction in blood loss and transfusion requirements, without compromising wound outcome.Keywords
This publication has 25 references indexed in Scilit:
- CHANGES IN TRANSFUSION PRACTICES IN BURN PATIENTSJournal Of Trauma-Injury Infection and Critical Care, 1994
- The effect of early surgical intervention on mortality and cost-effectiveness in burn care, 1978-91Burns, 1994
- The estimation of blood loss during burns surgeryBurns, 1993
- A PROSPECTIVE STUDY OF BLOOD LOSS WITH EXCISIONAL THERAPY IN PEDIATRIC BURN PATIENTSJournal Of Trauma-Injury Infection and Critical Care, 1993
- A quantitative assessment of blood loss in burn wound excision and graftingBurns, 1992
- Significant Reductions in Mortality for Children With Burn Injuries Through the Use of Prompt Eschar ExcisionAnnals of Surgery, 1988
- Epinephrine v Thrombin for Split-Thickness Donor Site HemostasisJournal of Burn Care & Rehabilitation, 1987
- Prompt Eschar ExcisionAnnals of Surgery, 1986
- Early Excision and Grafting vs. Nonoperative Treatment of Burns of Indeterminant DepthJournal Of Trauma-Injury Infection and Critical Care, 1983
- Early surgical excision versus conventional therapy in patients with 20 to 40 percent burns: A comparative studyThe American Journal of Surgery, 1982