Evaluation of blood ordering and usage in surgical procedures.

The objective of this study is to evaluate the blood ordering and usage in surgical procedures for 2 years after the revision of our maximum surgical blood order schedule (MSBOS) and type and screen (T & S) system.The number of surgical procedures ordered by T & S was increased to 38% of total number of procedures in 1993. Although T & S was not assigned for some procedures in pediatric and otolaryngology surgeries, the number of T & S procedures was increased in these surgeries. In lung lobectomy and brain tumor excision, for which 4 and 3 units of MSBOS were assigned, respectively, the volume of blood loss was less than 500ml and C/T ratios were increased. T & S should be assigned for these procedures. In radical mastectomy, C/T ratio was improved and the average number of cross-matched units was decreased after the change of assignment to T & S from MSBOS 3 units. Blood loss was approximately 1800ml in radical hysterectomy and radical resection of ovarial cancer because of the shift to more radical resection. Although C/T ratios were 1.4 and 1.9 in those procedures, MSBOS units should be increased to more than 5 in the both procedures. In surgical procedures with predeposit autologous blood, the number of T & S orders seemed to be increased, especially in cardiovascular surgery, instead of additional preoperative homologous blood preparation.MSBOS and T & S system should be re-evaluated after 6 months or 1 year period, thus, more effective blood utilization can be achieved.