The assessment of blood loss in orthognathic surgery for prognathia.

PURPOSE

It is difficult to predict the need for blood transfusion during orthognathic surgery. The purpose of this study was to evaluate differences between patients who underwent different orthognathic procedures, and to assess the need for transfusion in orthognathic surgery.

SUBJECTS AND METHODS

We examined 62 prognathic patients who underwent orthognathic surgery in our hospital. The subjects were divided into 4 groups according to procedure. Pre- and postoperative values of blood parameters were evaluated statistically.

RESULTS

A greater amount of blood was lost in the double-jaw surgeries than in the single-jaw surgeries. There was a significant difference between sagittal split ramus osteotomy (SSRO) combined with Le Fort I osteotomy and intraoral vertical ramus osteotomy (IVRO) ( P < .05). However, none of the patients required transfusion intraoperatively. In all groups except the IVRO group, there were significant differences in red blood cell count, hemoglobin, and hematocrit between preoperative values and 1 week postoperative values ( P < .05). Although the values of red blood cell, hemoglobin, and hematocrit tended to decrease until 2 weeks postoperative, no complications occurred. Simple regression analysis showed significant positive correlation between duration of operation and blood loss ( P < .05).

CONCLUSION

The present results indicate that there is little risk of marked bleeding in routine procedures, and that IVRO causes minimal bleeding. Transfusion was not necessary in IVRO or SSRO with or without Le Fort I osteotomy.