Adolf Lorenz, known as "the bloodless surgeon of Vienna," created bloodless surgery as a non-invasive surgical technique. His medical profession arose from his extreme sensitivity to carbolic acid, which was often utilized in operating rooms at the time. Because of his condition, he was obliged to work as a "dry surgeon." The phrase is now used to refer to both invasive and noninvasive medical treatments and processes. The phrase does not refer to surgery that does not include the use of blood or blood transfusions. Rather, it refers to surgery that is carried out without the use of allogeneic blood. Bloodless surgery advocates, on the other hand, transfuse goods derived from allogeneic blood (blood from other individuals) as well as pre-donated blood for autologous transfusion.
Some patients will refuse a blood or blood product transfusion due to personal choice or religious convictions. In other cases, preserving blood and limiting blood loss during surgery has resulted in safer treatments and quicker recoveries. Denton Cooley, an American cardiac surgeon, successfully conducted multiple bloodless open-heart surgeries on Jehovah's Witness patients in the early 1960s. Fifteen years later, he and his colleague demonstrated that heart surgery could be conducted successfully without the need of blood transfusions. To provide safe, effective, and clinically sound blood product alternatives, the different BMS programs have implemented innovative methodologies, built robust policies, and utilized technology.
Of course, transfusion will always play a vital role in healthcare, particularly in emergencies and for people suffering from blood diseases. However, extensive data now show that certain transfusions are not only preventable, but may also have a negative impact on patient outcomes. The concept that major surgery might be conducted without providing blood or blood products to the patient would have been regarded with widespread disbelief decades ago. Stored blood was used in a variety of settings, frequently without concern. It was just normal, and as such, it received little scientific examination. But, owing to certain dedicated, daring medical pioneers and religious leaders, we can now make a powerful message.
Almost no surgery, regardless of the location of the body being treated, necessitates the use of blood products, even organ transplants. It merely takes careful preparation.
Bloodless medicine and surgery is an established, safe, and successful technique of treating patients that does not include the use of blood or blood products such as red cells, white cells, platelets, and plasma. Best patient blood management is gradually becoming acknowledged as the gold standard of treatment in medicine and surgery across the country for optimal use of blood products. Blood conservation strategies not only enhance the management of a patient's blood, but they also minimize dependency on regional and national blood supplies, as well as the accompanying expenses.
Patients who choose bloodless treatment frequently have excellent outcomes as a result of: Healing periods are shorter, recovery times are shorter, fewer responses from blood that has been preserved for an extended amount of time, infections are less likely to occur, there are no hazards associated with obtaining the incorrect blood by mistake.
Implementing the finest patient blood management program benefits hospitals and health care companies by: Lowering the hospital's blood inventory maintenance expenses, reducing needless blood draws, lowering the likelihood of blood transfusion mistakes, lowering the risk of infection, reducing problems associated with blood storage, lowering the demand for blood and blood products.
Controlling bleeding in surgery is accomplished by the use of laser or sonic scalpels, minimally invasive surgical procedures, electrosurgery and electrocautery, low central venous pressure anesthesia (in certain circumstances), or vascular suture ligation. Other options include the use of blood substitutes, which do not now contain oxygen but increase the volume of the blood to avoid shock. PolyHeme, a blood replacement that does deliver oxygen, is also being developed. Many clinicians regard acute normovolemic hemodilution, a kind of blood storage, as a pillar of "bloodless surgery," although the procedure is not an option for patients who refuse autologous blood transfusions.
Intraoperative blood salvage is a procedure that recycles and cleans blood from a patient during surgery and reroutes it back into the patient's body. Postoperatively, surgeons attempt to reduce future blood loss by continuing to provide drugs to increase blood cell mass and reducing the number of blood draws and the amount of blood obtained for testing, such as by using pediatric blood tubes for adult patients. HBOCs like Polyheme and Hemepure have been withdrawn due to serious adverse responses, including death. They were only legally permitted as routine therapy in South Africa, but they are no longer available.