A New Method for Determining the Volume Of Blood Loss During Necrectomy in Patients With Deep Burns

Abstract

ABSTRACT

OBJECTIVES: Most surgery manuals indicate that, for excisions of a burn scab on an area of 1 cm2 with skin plasty, blood loss, taking into account donor zones, is about 1 mL. This volume of alleged blood loss plays an essential role in planning surgical treatment of patients with burn injuries. To date, when volume of lost blood is calculated with the use of existing methods for determining intraoperative blood loss, it is not recommended to excise necrotic tissues on an area of more than 15% of the body surface. In this study, our aim was to develop a new formula for determining intraoperative blood loss during necrectomy in patients with deep burns. MATERIALS AND METHODS: We developed and proposed our own, original method for determining the volume of intraoperative blood loss, based on taking into account hemoglobin and hematocrit indicators, as well as differentiated calculation of the volume of circulating blood. This technique was tested on 109 patients with deep burns (per ICD-10), who were admitted to our department from January 2022 to December 2022 because of thermal lesions. We processed obtained data using Microsoft Office Excel and used generally accepted methods of nonparametric statistics.

RESULTS: With the new formula, we determined blood loss of 0.52 mL per 1 cm2 of excised tissue, which is 2 times less than predicted by traditional methods.

CONCLUSIONS: Our results showed that the expected intraoperative blood loss may not be 1 mL/1 cm2, as currently prescribed in clinical guidelines, but 0.5 mL/1 cm2 of the excised tissue. Our results allow for possible expansion of the removal of the burn eschar before the development of infectious complications.