A prospective study of blood loss with excisional therapy in pediatric burn patients.

Major blood loss occurs with excisional therapy of burns. To our knowledge no studies have quantitated blood loss in pediatric patients. This prospective study was performed to analyze blood loss in a pediatric burn population undergoing excision and grafting. Forty-four patients underwent 50 two-stage procedures. Blood loss was determined based on calculations of red cells administered in conjunction with estimates of total circulating red cell numbers. Results showed a mean value (+/- SEM) of 2.8% +/- 0.23% of circulating volume lost as a percentage of total body surface area (TBSA) excised, whereas 1.8% +/- 0.18% of circulating volume was lost as a percentage of TBSA grafted. Assessment of losses by age and depth of wound, patient age, and anatomic site showed no differences between these groups. Tourniquets lowered intraoperative losses but had no effect on overall losses. The value of knowing blood losses precisely is evaluated in terms of efficiency of ordering blood.