Clinical experience of 184 cases of intentional normovolemic hemodilution in plastic surgery of the face
Lefèvre, J.C.; Laxenaire, M.C.; Stricker, M.; Drouet, N.; George, E.; Dopff, C.
Annales de Chirurgie Plastique et Esthetique 31(2): 189-192
1986
ISSN/ISBN: 0294-1260 PMID: 2429609 Document Number: 280827
Intentional isovolemic hemodilution (IIH) with maintenance of the hematocrit at around 0.30 was performed on 184 patients undergoing facial plastic surgery or maxillo-facial reconstructive surgery. The operative time averaged 10 hurs, with extremes of 6 and 23 hours. Blood was usually substantial, but IIH allowed major blood savings, as only 10 per cent of the patients required homologous blood transfusions. A more important factor was the apparently enhanced viability of the flaps under hemodilution, in comparison with more conventional techniques. This was due not only to better microcirculation and tissue oygenation, but also to the antiedemic effect of IIH, which is quite outstanding in the case of facial trauma. Although IIH has an anti-thrombotic effect, subcutaneous heparin seemed necessary for eight to ten days postoperatively to prevent thrombosisof the vascular anastomoses.