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Ranjbar A, Farazmehr K, Shojaei P. Investigating the Need for Blood Transfusion in Abdominoplasty and Liposuction Surgeries Under General Anesthesia in Farhikhtegan Hospital in 1401 and 1402. Journal of Iranian Blood Transfusion 2025; 22 (1) :44-53
URL: http://bloodjournal.ir/article-1-1553-en.html
Investigating the Need for Blood Transfusion in Abdominoplasty and Liposuction Surgeries Under General Anesthesia in Farhikhtegan Hospital in 1401 and 1402
Adnan Ranjbar , Kourosh Farazmehr , Parisa Shojaei *
Keywords: Abdominoplasty, Liposuction, Blood Transfusion, Anesthesia, Plastic Surgery, Hemoglobins
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Sci J Iran Blood Transfus Organ 2025; 22 (1): 46-55
Original Article
 
Investigating the Need for Blood Transfusion in
Abdominoplasty and Liposuction Surgeries Under General Anesthesia in Farhikhtegan Hospital in 1401 and 1402

Adnan Ranjbar1, Kourosh Farazmehr1        , Parisa Shojaei2



1Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
2Department of Community and Preventive Medicine, Social Determinants of Health Research Center, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran

 
Received: 2024/08/27
Accepted: 2025/03/15
 





       http://dx.doi.org/10.61186/bloodj.22.1.44
    



Citation:
Ranjbar A, Farazmehr K, Shojaei P. Investigating the Need for Blood Transfusion in Abdominoplasty and Liposuction Surgeries Under General Anesthesia in Farhikhtegan Hospital in 1401 and 1402. J Iran Blood Transfus. 2025: 22 (1) : 44-53.
    



Correspondence: Shojaei P., Associate Professor of Social Determinants of Health Research Center, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
P.O.Box: 193951495, Tehran, Iran.
Tel: (+9821) 88078388
E-mail:
1- Acridine Orange
1- Biological safety cabinet
1- Platelet Concentrate
2- Food and Drug Administration
3- Normal Skin Flora
4- Platelet Rich Plasma-Platelet Concentrate
5- Eosin-Methylene blue
6- Thioglycolate
1- Acridine Orange
1- Biological safety cabinet
1- Platelet Concentrate
2- Food and Drug Administration
3- Normal Skin Flora
4- Platelet Rich Plasma-Platelet Concentrate
5- Eosin-Methylene blue
6- Thioglycolate
shojaee7@gmail.com  		 A B S T R A C T
Background and Objectives
The need for blood transfusion in abdominoplasty and liposuction under general anesthesia is crucial factor in surgical planning and ensuring patient safety.
Materials and Methods
This cross-sectional study was conducted at Farhikhtegan Hospital in Tehran during 2022-2023. The study population included medical records of patients who were candidates for abdominoplasty and/or liposuction surgery with ASA class I and II, selected by census sampling. Collected data included age, sex, blood type, underlying diseases, volume of fluid administered, duration of anesthesia, and need for blood transfusion. Data were analyzed using SPSS version 26 applying independent t-tests, chi-squared tests, and one-way ANOVA, with a significance level set at < 0.05.
Results
A total of 107 patients with a mean age of 42.3 years and a mean preoperative hemoglobin level of 11.8 g/dL were studied. The majority were female (98.13%) and 72.9% were classified as risk group 1. The most common underlying diseases were hypertension (11.2%) and diabetes (9.3%). Blood type O+ was the most prevalent (28%), and 80.3% of patients underwent a combined liposuction and abdominoplasty. 65 (60.2%) of patients did not require a blood transfusion, while 42 (39.8%, 95% CI: 30.1%-48.5) received one unit of blood. Analyses showed a significant relationship between the type of surgery and the need for blood transfusion depending on the preoperative hemoglobin level. Notably, preoperative hemoglobin level had a significant effect on the blood transfusion need (95% CI: 0%-0.70.9%; p= 0.04). Patients with hemoglobin below 10 g/dL were more likely to require transfusion (75.0%). Among patients with hemoglobin levels between 10–12 g/dL, 41.2% required transfusion, while 29.4% of those with hemoglobin levels between 12–14 g/dL needed a transfusion. This pattern was observed in all three types of surgery. However, there was no significant association between blood transfusion and duration of anesthesia, risk level, underlying diseases, and volume of fluids administrated.
Conclusions 
Monitoring preoperative hemoglobin levels and managing fluids appropriately during surgery can significantly reduce the need for blood transfusions and improve clinical outcomes.
Key words: Abdominoplasty, Liposuction, Blood Transfusion, Anesthesia, Plastic Surgery, Hemoglobins




References:
  1. Campos R, Soley NA, Campos BV. Patient safety: changes in hemoglobin and serum iron after liposuction and/or abdominoplasty. Revista brasileira de cirurgia 2018; 33: 511-7. [DOI:10.5935/2177-1235.2018RBCP0172]
  2. Wu S, Coombs DM, Gurunian R. Liposuction: Concepts, safety, and techniques in body-contouring surgery. Cleveland Clinic Journal of Medicine 2020; 87(6): 367-75. [DOI:10.3949/ccjm.87a.19097] [PMID]
  3. Mortada H, Alshenaifi S, Samawi H, Marzoug M, Alhumsi T, Alaithan B. The Safety of Large-Amount Liposuction: A Retrospective Analysis of 28 Cases. J Cutan Aesthet Surg 2023; 16(3): 227-231. [DOI:10.4103/JCAS.JCAS_59_22] [PMID]
  4. Masoomi H, Rimler J, Wirth G, Lee C, Paydar K, Evans G. Frequency and Risk Factors of Blood Transfusion in Abdominoplasty in Post-Bariatric Surgery Patients. Plast Reconstr Surg 2015; 135: 861e-8e. [DOI:10.1097/PRS.0000000000001161] [PMID]
  5. Bayter-Marín JE, Hoyos A, Cárdenas-Camarena L, Peña-Pinzón W, Bayter-Torres AF, Díaz-Díaz CA, et al. Effectiveness of Tranexamic Acid in the Postoperative Period in Body Contour Surgery: Randomized Clinical Trial. Plast Reconstr Surg Glob Open 2023; 11(11): e5403. [DOI:10.1097/GOX.0000000000005403] [PMID]
  6. Floros C, Davis P. Complications and long-term results following abdominoplasty: a retrospective study. Br J Plast Surg 1991; 44(3): 190-4. [DOI:10.1016/0007-1226(91)90125-4] [PMID]
  7. Ahern RW. The history of liposuction. Semin Cutan Med Surg 2009; 28(4): 208-11. [DOI:10.1016/j.sder.2009.10.001] [PMID]
  8. Chia CT, Neinstein RM, Theodorou SJ. Evidence-based medicine: liposuction. Plast Reconstr Surg 2017; 139(1): 267e-74e. [DOI:10.1097/PRS.0000000000002859] [PMID]
  9. Swanson E. Prospective study of lidocaine, bupivacaine, and epinephrine levels and blood loss in patients undergoing liposuction and abdominoplasty. Plast Reconstr Surg 2012; 130(3): 702-22. [DOI:10.1097/PRS.0b013e31825dc408] [PMID]
  10. Marik PE, Corwin HL. Efficacy of red blood cell transfusion in the critically ill: a systematic review of the literature. Crit Care Med 2008; 36(9): 2667-74. [DOI:10.1097/CCM.0b013e3181844677] [PMID]
  11. Matarasso A, Swift RW, Rankin M. Abdominoplasty and abdominal contour surgery: a national plastic surgery survey. Plast Reconstr Surg 2006; 117(6): 1797-808. [DOI:10.1097/01.prs.0000209918.55752.f3] [PMID]
  12. Rohrich RJ, Leedy JE, Swamy R, Brown SA, Coleman J. Fluid resuscitation in liposuction: a retrospective review of 89 consecutive patients. Plast Reconstr Surg 2006; 117(2): 431-5. [DOI:10.1097/01.prs.0000201477.30002.ce] [PMID]
  13. JA K. The tumescent technique for liposuction surgery. Am J Cosmet Surg 1987; 4: 263-7. [DOI:10.1177/074880688700400403]
  14. Iverson R, Lynch D. American Society of Plastic Surgeons Committee on Patient Safety. Practice advisory on liposuction. Plast Reconstr Surg 2004; 113(5): 1478-90. [DOI:10.1097/01.PRS.0000111591.62685.F8] [PMID]
  15. Samdal F, Amland PF, Bugge JF. Blood loss during liposuction using the tumescent technique. Aesthetic Plast Surg 1994; 18: 157-60. [DOI:10.1007/BF00454476] [PMID]
  16. Haeck PC, Swanson JA, Iverson RE, Schechter LS, Singer R, Basu CB, et al. Evidence-based patient safety advisory: patient selection and procedures in ambulatory surgery. Plast Reconstr Surg 2009; 124(4S): 6S-27S. [DOI:10.1097/PRS.0b013e3181b8e880] [PMID]
  17. Cárdenas-Camarena L, Gerardo L-PA, Durán H, Bayter-Marin JE. Strategies for reducing fatal complications in liposuction. Plast Reconstr Surg Glob Open 2017; 5(10): e1539. [DOI:10.1097/GOX.0000000000001539] [PMID]
  18. Hunstad JP, Godek CP, Van Natta BW, Kortesis BG, Bharti G, Crantford JC, et al. A multicenter, prospective, randomized, contralateral study of tissue liquefaction liposuction vs suction-assisted liposuction. Aesthet Surg J 2018; 38(9): 980-9. [DOI:10.1093/asj/sjy001] [PMID]
  19. Klein JA. Tumescent technique for regional anesthesia permits lidocaine doses of 35 mg/kg for liposuction. J Dermatol Surg Oncol 1990; 16(3): 248-63. [DOI:10.1111/j.1524-4725.1990.tb03961.x] [PMID]
  20. Di Giuseppe A, Shiffman MA. Liposuction--Principles and Practice. Philadelphia: Springer; 2016. p: 87-94.
  21. Rohrich RJ, Mendez BM, Afrooz PN. An update on the safety and efficacy of outpatient plastic surgery: a review of 26,032 consecutive cases. Plast Reconstr Surg 2018; 141(4): 902-8. [DOI:10.1097/PRS.0000000000004213] [PMID]
  22. Neaman  KC,  Hansen  JE. Analysis  of complications from abdominoplasty: a review of 206 cases at a university hospital. Ann Plast Surg 2007; 58(3): 292-8. [DOI:10.1097/01.sap.0000239806.43438.54] [PMID]
  23. Kaoutzanis C, Gupta V, Winocour J, Shack B, Grotting JC, Higdon K. Incidence and risk factors for major surgical site infections in aesthetic surgery: Analysis of 129,007 Patients. Aesthet Surg J 2017; 37(1): 89-99. [DOI:10.1093/asj/sjw100] [PMID]
  24. Stephan PJ, Kenkel JM. Updates and advances in liposuction. Aesthet Surg J 2010; 30(1): 83-97. [DOI:10.1177/1090820X10362728] [PMID]
  25. Chow I, Alghoul MS, Khavanin N, Hanwright PJ, Mayer KE, Hume KM, et al. Is there a safe lipoaspirate volume? A risk assessment model of liposuction volume as a function of body mass index. Plast Reconstr Surg 2015; 136(3): 474-83. [DOI:10.1097/PRS.0000000000001498] [PMID]
  26. Coon D, Joseph Michaels V, Gusenoff JA, Purnell C, Friedman T, Rubin JP. Multiple procedures and staging in the massive weight loss population. Plast Reconstr Surg 2010; 125(2): 691-8. [DOI:10.1097/PRS.0b013e3181c87b3c] [PMID]







   
Type of Study: Research | Subject: Blood Transfusion
References
1. Campos R, Soley NA, Campos BV. Patient safety: changes in hemoglobin and serum iron after liposuction and/or abdominoplasty. Revista brasileira de cirurgia 2018; 33: 511-7. [DOI:10.5935/2177-1235.2018RBCP0172]
2. Wu S, Coombs DM, Gurunian R. Liposuction: Concepts, safety, and techniques in body-contouring surgery. Cleveland Clinic Journal of Medicine 2020; 87(6): 367-75. [DOI:10.3949/ccjm.87a.19097] [PMID]
3. Mortada H, Alshenaifi S, Samawi H, Marzoug M, Alhumsi T, Alaithan B. The Safety of Large-Amount Liposuction: A Retrospective Analysis of 28 Cases. J Cutan Aesthet Surg 2023; 16(3): 227-231. [DOI:10.4103/JCAS.JCAS_59_22] [PMID] []
4. Masoomi H, Rimler J, Wirth G, Lee C, Paydar K, Evans G. Frequency and Risk Factors of Blood Transfusion in Abdominoplasty in Post-Bariatric Surgery Patients. Plast Reconstr Surg 2015; 135: 861e-8e. [DOI:10.1097/PRS.0000000000001161] [PMID]
5. Bayter-Marín JE, Hoyos A, Cárdenas-Camarena L, Peña-Pinzón W, Bayter-Torres AF, Díaz-Díaz CA, et al. Effectiveness of Tranexamic Acid in the Postoperative Period in Body Contour Surgery: Randomized Clinical Trial. Plast Reconstr Surg Glob Open 2023; 11(11): e5403. [DOI:10.1097/GOX.0000000000005403] [PMID] []
6. Floros C, Davis P. Complications and long-term results following abdominoplasty: a retrospective study. Br J Plast Surg 1991; 44(3): 190-4. [DOI:10.1016/0007-1226(91)90125-4] [PMID]
7. Ahern RW. The history of liposuction. Semin Cutan Med Surg 2009; 28(4): 208-11. [DOI:10.1016/j.sder.2009.10.001] [PMID]
8. Chia CT, Neinstein RM, Theodorou SJ. Evidence-based medicine: liposuction. Plast Reconstr Surg 2017; 139(1): 267e-74e. [DOI:10.1097/PRS.0000000000002859] [PMID]
9. Swanson E. Prospective study of lidocaine, bupivacaine, and epinephrine levels and blood loss in patients undergoing liposuction and abdominoplasty. Plast Reconstr Surg 2012; 130(3): 702-22. [DOI:10.1097/PRS.0b013e31825dc408] [PMID]
10. Marik PE, Corwin HL. Efficacy of red blood cell transfusion in the critically ill: a systematic review of the literature. Crit Care Med 2008; 36(9): 2667-74. [DOI:10.1097/CCM.0b013e3181844677] [PMID]
11. Matarasso A, Swift RW, Rankin M. Abdominoplasty and abdominal contour surgery: a national plastic surgery survey. Plast Reconstr Surg 2006; 117(6): 1797-808. [DOI:10.1097/01.prs.0000209918.55752.f3] [PMID]
12. Rohrich RJ, Leedy JE, Swamy R, Brown SA, Coleman J. Fluid resuscitation in liposuction: a retrospective review of 89 consecutive patients. Plast Reconstr Surg 2006; 117(2): 431-5. [DOI:10.1097/01.prs.0000201477.30002.ce] [PMID]
13. JA K. The tumescent technique for liposuction surgery. Am J Cosmet Surg 1987; 4: 263-7. [DOI:10.1177/074880688700400403]
14. Iverson R, Lynch D. American Society of Plastic Surgeons Committee on Patient Safety. Practice advisory on liposuction. Plast Reconstr Surg 2004; 113(5): 1478-90. [DOI:10.1097/01.PRS.0000111591.62685.F8] [PMID]
15. Samdal F, Amland PF, Bugge JF. Blood loss during liposuction using the tumescent technique. Aesthetic Plast Surg 1994; 18: 157-60. [DOI:10.1007/BF00454476] [PMID]
16. Haeck PC, Swanson JA, Iverson RE, Schechter LS, Singer R, Basu CB, et al. Evidence-based patient safety advisory: patient selection and procedures in ambulatory surgery. Plast Reconstr Surg 2009; 124(4S): 6S-27S. [DOI:10.1097/PRS.0b013e3181b8e880] [PMID]
17. Cárdenas-Camarena L, Gerardo L-PA, Durán H, Bayter-Marin JE. Strategies for reducing fatal complications in liposuction. Plast Reconstr Surg Glob Open 2017; 5(10): e1539. [DOI:10.1097/GOX.0000000000001539] [PMID] []
18. Hunstad JP, Godek CP, Van Natta BW, Kortesis BG, Bharti G, Crantford JC, et al. A multicenter, prospective, randomized, contralateral study of tissue liquefaction liposuction vs suction-assisted liposuction. Aesthet Surg J 2018; 38(9): 980-9. [DOI:10.1093/asj/sjy001] [PMID] []
19. Klein JA. Tumescent technique for regional anesthesia permits lidocaine doses of 35 mg/kg for liposuction. J Dermatol Surg Oncol 1990; 16(3): 248-63. [DOI:10.1111/j.1524-4725.1990.tb03961.x] [PMID]
20. Di Giuseppe A, Shiffman MA. Liposuction--Principles and Practice. Philadelphia: Springer; 2016. p: 87-94.
21. Rohrich RJ, Mendez BM, Afrooz PN. An update on the safety and efficacy of outpatient plastic surgery: a review of 26,032 consecutive cases. Plast Reconstr Surg 2018; 141(4): 902-8. [DOI:10.1097/PRS.0000000000004213] [PMID]
22. Neaman KC, Hansen JE. Analysis of complications from abdominoplasty: a review of 206 cases at a university hospital. Ann Plast Surg 2007; 58(3): 292-8. [DOI:10.1097/01.sap.0000239806.43438.54] [PMID]
23. Kaoutzanis C, Gupta V, Winocour J, Shack B, Grotting JC, Higdon K. Incidence and risk factors for major surgical site infections in aesthetic surgery: Analysis of 129,007 Patients. Aesthet Surg J 2017; 37(1): 89-99. [DOI:10.1093/asj/sjw100] [PMID]
24. Stephan PJ, Kenkel JM. Updates and advances in liposuction. Aesthet Surg J 2010; 30(1): 83-97. [DOI:10.1177/1090820X10362728] [PMID]
25. Chow I, Alghoul MS, Khavanin N, Hanwright PJ, Mayer KE, Hume KM, et al. Is there a safe lipoaspirate volume? A risk assessment model of liposuction volume as a function of body mass index. Plast Reconstr Surg 2015; 136(3): 474-83. [DOI:10.1097/PRS.0000000000001498] [PMID]
26. Coon D, Joseph Michaels V, Gusenoff JA, Purnell C, Friedman T, Rubin JP. Multiple procedures and staging in the massive weight loss population. Plast Reconstr Surg 2010; 125(2): 691-8. [DOI:10.1097/PRS.0b013e3181c87b3c] [PMID]
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