EP.TH.860Audit to review the post-operative blood transfusion rate in open hernia repairs in order to reduce the number of pre-operative Group and Save Tests obtained. (28th October 2021)

• Record Type: Journal Article
• Authors: Cormack, Jonathan; Wong, Nicholas
• Is Part Of: British journal of surgery. Volume 108:Supplement 7(2021)
• Publication Date: 2021-10-28
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjs/znab309.087
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Aims: Open hernia repair is a common elective and emergency surgical procedure. The majority of hernia repairs are performed without complications. Current dogma dictates 2 pre-operative group and save tests must be obtained prior to hernia repair. Post-operative haemorrhage is rare and there is equipoise as to whether all patients must be group and saved pre-operatively. Methods: Retrospective review of electronic patient records between April 2018 to March 2019 in a large district general hospital. Cross referencing of operative, blood transfusion and blood science records was performed. Results: 410 open hernia repairs including inguinal, femoral and all other abdominal wall hernias were performed. The hernia repairs were elective and emergency procedures with patients ASA 1 - 5. A total of 820 pre-operative group and save test were obtained with a total cost of £7, 978.60. The post-operative blood transfusion rate was 1.46%. Conclusions: A large number of open hernia repairs were performed over a 12-month period with a very low post-operative blood transfusion rate. This small single centre study indicates that many pre-operative group and save tests may be unnecessary as the majority of hernia repairs were performed without post-operative blood transfusion. Abolishing unnecessary group and save tests could reduce clinical and financial burden without compromising patient safety. The study also suggests that a selective group and save policy be instituted for certain patient characteristics such as emergency repair, ASA ≥3 or abdominal wall reconstruction for incisional hernia. A selective group and save policy will be implemented and re-audit in 6 months.