Blood loss during extensive escharectomy and auto-microskin grafting in adult male major burn patients

Purpose: To improve the accuracy of blood loss estimation during extensive escharectomy and auto-microskin grafting on extremities in adult male major burn patients. Method: All adult male major burn patients admitted to our center who underwent extensive escharectomy and auto-microskin graft on extremities for more than 10%TBSA during the period 1 January 2008 to 31 December 2009 were involved in this study. The blood loss during the operation was estimated by the surgeons or calculated according to the changes in hemoglobin levels. Results: The average burn and escharectomy areas for the 64 burn patients included in the study were 74.16 ± 16.96% and 30.27 ± 15.63%TBSA respectively. The auto-microskin donor area was 3.81%TBSA. The volumes of intra-operative calculated and estimated blood losses and transfused blood during the operation were 0.47 ml/cm², 0.13 ml/cm² and 0.20 ml/cm² surgical area 77.29 ml, 20.51 ml and 32.83 ml per 1%TBSA), respectively. Within two weeks after injury surgical blood loss appeared to be greater the later the operation was carried out. Within the first week after injury the mean proportional blood loss was increased with area excised. Conclusion: In this study the average calculated blood loss for the operation of extensive escharectomy and microskin graft in adult male major burn patient was 0.47 ml/cm² (77.29 ml per 1% TBSA). This result will help us to predict expected blood loss more accurately.