Calculated Versus Estimated Blood Loss in Plastic Breast Surgery
Background:. Estimated blood loss (EBL), based on surgeons’ visual estimation of blood loss, guides patient care but is often inaccurate. Calculated blood loss (CBL), a measurement of the volume of blood lost, is a more accurate substitute. Our aim was to assess the differences between EBL and CBL i...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2025-08-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006988 |
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| author | Carly M. Wareham, MD Gabriel De La Cruz Ku, MD Manish M. Karamchandani, MD Abhishek Chatterjee, MD, MBA, FACS Sarah M. Persing, MD, MPH Christopher Homsy, MD |
| author_facet | Carly M. Wareham, MD Gabriel De La Cruz Ku, MD Manish M. Karamchandani, MD Abhishek Chatterjee, MD, MBA, FACS Sarah M. Persing, MD, MPH Christopher Homsy, MD |
| author_sort | Carly M. Wareham, MD |
| collection | DOAJ |
| description | Background:. Estimated blood loss (EBL), based on surgeons’ visual estimation of blood loss, guides patient care but is often inaccurate. Calculated blood loss (CBL), a measurement of the volume of blood lost, is a more accurate substitute. Our aim was to assess the differences between EBL and CBL in plastic surgery.
Methods:. A retrospective analysis was conducted on 35 patients who underwent deep inferior epigastric perforator flaps, oncoplastic surgery, breast reductions, or mastectomies in 1 hospital over 18 months.
Results:. The surgeons underestimated EBL (median EBL 250 versus CBL 388 cc, P < 0.001). EBL and CBL from surgeon 2, a senior surgeon, were not statistically different compared with those of surgeon 1 (250 versus 250 cc, P = 0.958; 363 versus 501 cc, P = 0.143), but tended to have less delta EBL–CBL (113 versus 273 cc, P = 0.066). Both breast reductions/mastectomies and deep inferior epigastric perforators had higher CBL (200 versus 360 cc, P < 0.001; 300 versus 748 cc, P = 0.015), but less delta EBL–CBL (116 versus 438 cc, P = 0.054). There was a strong negative relationship between EBL and postoperative hemoglobin, and a moderate relationship between CBL and delta EBL–CBL with case duration, intraoperative fluids, and urine output.
Conclusions:. The surgeons underestimate blood loss, but the senior surgeon tended to do so to a lesser extent. Complex and longer procedures tended to have a greater discrepancy between EBL and CBL. CBL should be considered as a reliable alternative to EBL. |
| format | Article |
| id | doaj-art-86e827731f574f4aa4a968914b375176 |
| institution | Kabale University |
| issn | 2169-7574 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj-art-86e827731f574f4aa4a968914b3751762025-08-26T03:24:29ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742025-08-01138e698810.1097/GOX.0000000000006988202508000-00049Calculated Versus Estimated Blood Loss in Plastic Breast SurgeryCarly M. Wareham, MD0Gabriel De La Cruz Ku, MD1Manish M. Karamchandani, MD2Abhishek Chatterjee, MD, MBA, FACS3Sarah M. Persing, MD, MPH4Christopher Homsy, MD5From the * Department of Surgery, Tufts Medical Center, Boston, MA† Universidad Científica del Sur, Lima, PeruFrom the * Department of Surgery, Tufts Medical Center, Boston, MA‡ Division of Plastic and Reconstructive Surgery, Department of Surgery, Tufts Medical Center, Boston, MA‡ Division of Plastic and Reconstructive Surgery, Department of Surgery, Tufts Medical Center, Boston, MA‡ Division of Plastic and Reconstructive Surgery, Department of Surgery, Tufts Medical Center, Boston, MABackground:. Estimated blood loss (EBL), based on surgeons’ visual estimation of blood loss, guides patient care but is often inaccurate. Calculated blood loss (CBL), a measurement of the volume of blood lost, is a more accurate substitute. Our aim was to assess the differences between EBL and CBL in plastic surgery. Methods:. A retrospective analysis was conducted on 35 patients who underwent deep inferior epigastric perforator flaps, oncoplastic surgery, breast reductions, or mastectomies in 1 hospital over 18 months. Results:. The surgeons underestimated EBL (median EBL 250 versus CBL 388 cc, P < 0.001). EBL and CBL from surgeon 2, a senior surgeon, were not statistically different compared with those of surgeon 1 (250 versus 250 cc, P = 0.958; 363 versus 501 cc, P = 0.143), but tended to have less delta EBL–CBL (113 versus 273 cc, P = 0.066). Both breast reductions/mastectomies and deep inferior epigastric perforators had higher CBL (200 versus 360 cc, P < 0.001; 300 versus 748 cc, P = 0.015), but less delta EBL–CBL (116 versus 438 cc, P = 0.054). There was a strong negative relationship between EBL and postoperative hemoglobin, and a moderate relationship between CBL and delta EBL–CBL with case duration, intraoperative fluids, and urine output. Conclusions:. The surgeons underestimate blood loss, but the senior surgeon tended to do so to a lesser extent. Complex and longer procedures tended to have a greater discrepancy between EBL and CBL. CBL should be considered as a reliable alternative to EBL.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006988 |
| spellingShingle | Carly M. Wareham, MD Gabriel De La Cruz Ku, MD Manish M. Karamchandani, MD Abhishek Chatterjee, MD, MBA, FACS Sarah M. Persing, MD, MPH Christopher Homsy, MD Calculated Versus Estimated Blood Loss in Plastic Breast Surgery Plastic and Reconstructive Surgery, Global Open |
| title | Calculated Versus Estimated Blood Loss in Plastic Breast Surgery |
| title_full | Calculated Versus Estimated Blood Loss in Plastic Breast Surgery |
| title_fullStr | Calculated Versus Estimated Blood Loss in Plastic Breast Surgery |
| title_full_unstemmed | Calculated Versus Estimated Blood Loss in Plastic Breast Surgery |
| title_short | Calculated Versus Estimated Blood Loss in Plastic Breast Surgery |
| title_sort | calculated versus estimated blood loss in plastic breast surgery |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006988 |
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