"Anyone dealing with blood and surgical patients should consider bloodless surgery." Joachim Boldt, Professor of Anaesthesiology, Ludwigshafen.
The AIDS tragedy has forced scientists and doctors to take additional steps to make the operating room safer. This obviously means a stricter blood test. However, experts say that even these measures do not guarantee risk-free transfusions. “Although society is spending tremendous resources making the blood supply safer than ever,” says the transfusion magazine, “we believe that patients will continue to try to avoid allogeneic [donor] transfusions just because the blood supply is never completely safe . ""
Unsurprisingly, many doctors are careful when giving blood. "Blood transfusions are generally not good and we avoid them very aggressively for everyone," said Dr. Alex Zapolanski from San Francisco, California.
The general public is also becoming aware of the dangers of transfusions. A 1996 survey found that 89% of Canadians would prefer an alternative to donating blood. "Not all patients will refuse homologous transfusions like Jehovah's Witnesses do," says the Journal of Vascular Surgery. "However, the risks of disease transmission and immunomodulation clearly show that we need to find alternatives for all of our patients."
A preferred method
Fortunately, there is an alternative: surgery and bloodless medicine. Many patients see it not as a last resort but as the treatment of choice and for good reason. Stephen Geoffrey Pollard, a UK consultant surgeon, notes that morbidity and mortality rates in patients undergoing bloodless surgery are "at least as good as those in patients receiving blood and, in many cases, infection. And infections are avoided Postoperative complications are often attributed to blood. "
How was the bloodless medical treatment developed? In a sense, the question is quite strange as the bloodless medicine precedes the use of blood. In fact, it wasn't until the early 1900s that transfusion technology advanced to the point where it was used routinely. However, in the past few decades some have popularized the field of bloodless surgery. For example, in the 1960s, noted surgeon Denton Cooley performed some of the first bloodless open heart surgery.
With the rise in hepatitis among transfusion recipients in the 1970s, many doctors began looking for alternatives to blood. In the 1980s, several large medical teams performed bloodless surgeries. Then when the AIDS epidemic broke out, these teams were consulted several times by other people who wanted to use the same techniques. In the 1990s, many hospitals developed programs that gave their patients bloodless options.
Doctors have already successfully used bloodless techniques in emergency surgery and procedures that traditionally required transfusions. "Major cardiac, vascular, gynecological and obstetric, orthopedic and urological surgeries can be successfully performed without the use of blood or blood products," notes D.H.W. Wong, in the Canadian Journal of Anesthesia.
One of the benefits of bloodless surgery is that it promotes better quality care. "The surgeon's skills are critical to preventing blood loss," says Dr. Benjamin J. Reichstein, director of operations in Cleveland, Ohio. A South African legal journal says that in some cases, bloodless surgery can be "faster, cleaner, and cheaper". He adds: "Of course, in many cases, post-processing was cheaper and takes less time." These are just some of the reasons why around 180 hospitals worldwide offer special bloodless surgery and medicine programs.