Journal d'otologie et de rhinologie

Transfusion of Aged Blood in Head and Neck Free Flap Surgery: Perioperative Outcomes Analysis

Scott Koepsell, Mina Le, Amy Anne Lassig, Bruce Lindgren, Claudia Cohn, Samir S Khariwala

Transfusion of Aged Blood in Head and Neck Free Flap Surgery: Perioperative Outcomes Analysis

Background: Transfusion of aged red blood cells (RBCs), those that are near their expiration date, occurs commonly at tertiary medical centers and is associated with decreased tissue oxygenation. Patients who undergo microvascular free tissue reconstruction of the head and neck may be particularly sensitive to old RBCs because the anastomosis and microvasculature of the flap require smooth flow and sufficient blood flow and oxygenation, respectively.

Methods: A retrospective review of clinical and laboratory data in a series of consecutive cases of microvascular reconstruction receiving blood transfusions was performed at a tertiary academic medical center. All patients undergoing ablative surgery of the head and neck with free flap reconstruction between September 2007 and March 2011 were selected. Rates of neck infection, wound dehiscence, free flap loss, need to return to the operating room for revision surgery, infection at the free flap donor site, and mortality were assessed as was age of RBCs transfused preoperatively or postoperatively.