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Contemporary usage of "bloodless surgery" refers to both invasive and noninvasive medical techniques and protocols. The term is somewhat confusing. The expression does not mean surgery that makes no use of blood or blood transfusion. Rather, it refers to surgery performed without transfusion of allogeneic blood. Champions of bloodless surgery do, however, transfuse products made from allogeneic blood and they also make use of predonated blood for autologous transfusion. The last twenty years have witnessed a surge of interest in bloodless surgery, for a variety of reasons. Jehovah's Witnesses reject blood transfusions on religious grounds; others may be concerned about bloodborne diseases, such as hepatitis and AIDS.
Additional recommended knowledge
Principles of bloodless surgery
Several principles of bloodless surgery have been published.
In surgery, control of bleeding is achieved with the use of laser or sonic scalpels, minimally invasive surgical techniques, electrocautery, low central venous pressure anesthesia (for select cases), or suture ligation of vessels. Other methods include the use of blood substitutes, which at present do not carry oxygen but expand the volume of the blood to prevent shock. Blood substitutes which do carry oxygen, such as PolyHeme, are also under development. Many doctors view acute normovolemic hemodilution, a form of storage of a patient's own blood, as a pillar of "bloodless surgery" but the technique is not an option for patients who refuse autologous blood transfusions.
The Cell Saver is a device which recycles and cleans blood from a patient during an operation and redirects it into the patient's body, a technique called intraoperative blood salvage or cell salvage.
Postoperatively, surgeons seek to minimize further blood loss by continuing administration of medications to augment blood cell mass and minimizing the number of blood draws and the quantity of blood drawn for testing, for example by using pediatric blood tubes for adult patients.
Bloodless medicine appeals to many doctors because it carries low risk of post-operative infection when compared with procedures requiring blood transfusion. Additionally, it is cost-saving. The cost of blood in the US hovers around $500 a unit, including testing. These costs are further increased as, according to Jan Hoffman (an administrator for the blood conservation program at Geisinger Medical Center in Danville, Pennsylvania), hospitals must pick up the tab for the first three units of blood infused per patient per calendar year. By contrast, hospitals may be reimbursed for drugs that boost a patient's red blood cell count, a treatment approach often used before and after surgery to reduce the need for a blood transfusion. Geisinger Medical Center began a blood conservation program in 2005 and reported a recorded savings of $273,000 in its first six months of operation.
Hospitals and medical centers with bloodless medicine programs
Further information about bloodless surgery
|This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Bloodless_surgery". A list of authors is available in Wikipedia.|