Blood conservation in massive suction lipectomy.

The practice of massive liposuction for the treatment of patients with large lipodystrophies has already been reported. The safety of this technique lies in proper fluid and blood replacement. Blood conservation techniques are therefore needed to avoid or minimize homologous transfusion. The use of a combination of predeposited autologous blood and acute intraoperative normovolemic hemodilution in the management of 150 patients requiring massive liposuction is reported. Since it is possible to anticipate the amount of blood loss in liposuction, a formula is proposed to monitor the hematocrit of the patient during the procedure and therefore predict the need for homologous transfusion. The technique reported enabled us to aspirate up to 11 liters in a single stage. Homologous transfusion was either avoided or markedly reduced. The degree of patient satisfaction was high, with no mortality or morbidity reported.