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Postoperative changes related to intraoperative blood transfusions.

OBJECTIVE
Wound infection, flap necrosis rates and peripheral complete blood cell count changes related to intraoperative whole-blood transfusions were investigated.


BACKGROUND
Evidence is growing that whole-blood cell transfusions are immunosuppressive and predispose patients to postoperative infections.


METHODS
102 female breast carcinoma patients with hemoglobin levels = 10 g/dl before modified radical mastectomy and < 10 g/dl intraoperatively but with no signs of oxygen debt were included. Group I included patients who had received two units of whole-blood transfusions intraoperatively. Patients who had received no transfusion were in group II. Peripheral complete blood cell count, wound infection rates and flap necrosis were compared.


RESULTS
Perioperative neutrophile and monocyte count increased in both groups. This increase was especially significant in the transfused group (p < 0.05). In both groups, these changes returned to normal levels on the tenth postoperative day. The decreased perioperative basophile count did not return to the baseline even on the tenth postoperative day in group I (p < 0.05). Lymphocyte count, and flap necrosis did not differ between the groups (p > 0.05). Wound infection seemed to take place and increase in the transfused group (p < 0.05).


CONCLUSION
Two units of whole-blood transfusions seem to increase wound infection and decrease basophile count in this series (Tab. 3, Ref. 30).