Comparative evaluation of the informative value of methods for determining the volume of intraoperative blood loss in the surgical treatment of burn victims

Abstract

The OBJECTIVE was to evaluate the informative value of various methods for determining the volume of blood loss during early surgical excision with simultaneous skin grafting with split grafts in patients with full thickness burns.MATERIAL AND METHODS. Our study included 10 patients with burns more than 20 % TBSA. In these patients, from the 2nd to the 5th day after the burn, fascial surgical excision with simultaneous skin grafting with perforated split grafts was performed. To assess the volume of operative blood loss, we used visual, empirical (B. S. Vikhriev; 1986, I. V. Chmyrev; 2011, T. A. Housinger; 1993, T. Janezic; 1997) and calculated (J. B. Gross; 1983, P. G. Budny; 1993, G. D. Warden; 1982) methods. The obtained data were processed by the generally accepted methods of nonparametric statistics.RESULTS. The minimum volume of blood loss was ascertained by visual assessment. We observed the maximum losses in the same patients when using calculated methods. In 5 out of 10 patients, the difference between the minimum and maximum results obtained using different methods exceeded 1000 %.CONCLUSION. Most of the methods used in burn surgery for determining the volume of surgical blood loss are insufficiently representative. To determine the optimal tactics for surgical treatment of patients with severe burns, it is necessary to create formulas for assessing the volume of blood loss, which will take into account laboratory parameters, features of surgical treatment, hydrobalance indicators, anthropometric data and other variables with high predictive value.

Keywords

• burns
• burn disease
• bleeding
• volume of blood loss
• excision
• skin grafting
• hemodilution