The practice of bloodless medicine and surgery, which is the only option for certain patients, is relatively new.
It was developed in an effort to reduce blood loss and the need for transfusions of blood and its products, as allogeneic blood transfusion has been historically linked to risks and complications.
Some of them have been mitigated to a great extent, but others are still harder to combat.
Blood transfusions are also expensive and blood supply is limited.
Based on statistics, transfusion is not really beneficial for a large number of patients who are transfused.
Although most people understand ‘bloodless medicine and surgery’ as the avoidance of donor blood transfusion, in practice it requires striking a balance between the risks and benefits of the avoidance of transfusion, being aware of a wide range of blood loss minimization techniques and methods and using autologous alternatives.
Clearly, however, its core philosophy consists in avoiding blood transfusion while at the same time providing the patient with care that ensures the best possible outcome.
With that aim in mind, scientists looked for practical solutions to reduce the problems and complications of blood transfusion.
What gave rise to the search for alternatives to the use of allogeneic blood was the fact that certain patients refused the transfusion of blood or its products as part of their medical care.
Many, like Jehovah’s Witnesses, refuse blood transfusion due to their religious beliefs, while others do so due to health problems, knowledge of the likely complications or other personal beliefs.
After years of successful research, we are now able to treat our patients who are in need of orthopedic surgery by the use of safe and effective bloodless surgical techniques.
Therefore, we are able to mitigate the risks of transfusion and obtain optimal surgery results and outcomes for patients who cannot be transfused owing to their needs or wishes.
This can be achieved by applying international standards of care consisting in the management of the patient’s own blood, namely using scientific methods to reduce anemia, perioperative blood conservation, surgical hemostasis and, if possible, drugs.
Three core principles can be used to attain these goals, which are important for an innovative and patient-centered approach:
(a) optimizing patient erythropoiesis;
(b) minimizing blood loss; and
(c) optimizing and utilizing one’s natural ability to deal with anemia.
Each one of these three core principles is a strategy that can be used in any situation that could result in undesirable outcomes and cause blood loss, thus necessitating the use of allogeneic blood transfusion.
Scientific evidence from clinical studies has demonstrated that that proper blood management is beneficial for patient health in many ways.
More specifically, patients who are not transfused recover faster and resume their day-to-day activities earlier.
Most importantly, though, they have fewer intraoperative and postoperative complications, including heart attacks, strokes and infections.
They also face a lower risk of immune complications and allergic reactions and of exposure to viruses and blood-borne infections.
Regardless of the reasons why a patient opts for bloodless surgery, the only thing they have to do is notify Dr Triantafyllopoulos early enough, so that appropriate preparation can be made and necessary guidance can be given.