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AIDS Services

Individuals with HIV suffer from compromised immune systems and therefore the avoidance of donated blood in order to alleviate the risk, however small, of transferring blood-borne pathogens, is especially appropriate for these patients. While many HIV-positive patients are also anemic and typically receive multiple transfusions to treat the anemia, the University Center for Bloodless Surgery and Medicine utilizes appropriate pharmaceutical interventions and preventive techniques to restore normal hemoglobin levels.

Anesthesiology

There are many techniques that can be used during surgery by the anesthesiology department to minimize blood loss. Hypotensive anesthesia involves reducing the patient’s blood pressure to a much lower, yet still safe, level that results in a decreased amount of blood loss. Hemodilution involves the dilution of the patient’s blood immediately prior to surgery so that the number of red blood cells lost during surgery are reduced. The anesthesiologist plays a major role in bloodless surgery and the University Center for Bloodless Surgery and Medicine offers the complete commitment to this practice by a dedicated core of physicians.

Cardiac Surgery

Use of Beating Heart Coronary Artery Bypass in many cases is replacing more conventional methods of cardiac surgery. The benefits of this type of surgery are shorter lengths of stay, fewer complications, and reduced risk of bleeding. Conventional open heart surgery at the University Center for Bloodless Surgery and Medicine is performed with skill and careful planning by conservation of the patient's own blood supply, careful intraoperative technique and the utilization of chemical and mechanical techniques for controlling bleeding.

Cardiology

Diagnostic cardiac catheterization, percutaneous coronary angioplasty, and balloon angioplasty are all performed with meticulous techniques that include the use of a silicon washer, which results in minimal to no blood loss.

Cancer Surgery

Blood loss during surgery can be minimized by using extra caution and deliberate operative techniques – avoiding unnecessary small cuts, immediate clamping or cauterizing of bleeding vessels, and the use of non-traditional cutting scalpels, such as argon beam coagulators and surgical lasers. For patients experiencing pre- or post-operative anemia, medications can be given to boost the ability of the bone marrow to make more red blood cells.

General Surgery

In some cases, laparoscopic and endoscopic procedures can be used instead of open conventional surgery to minimize blood loss, decrease the length of the hospital stay, and reduce patient discomfort. Where this is not possible and conventional surgery is indicated, our surgeons use careful pre-operative preparation, deliberate surgical technique, and the post-operative use of medications to counter anemia.

Hematology

Advances in pharmaceuticals have made it possible to increase a patient’s own blood supply through use of medications and supplements. These agents can be used to manage patients with anemia, thrombocytopenia (low platelet count), HIV, cancer, and a host of blood disorders. Physicians at the University Center For Bloodless Surgery And Medicine have developed advanced treatment protocols to provide the most effective care to patients who wish to avoid blood transfusions.

Neonatology

Because of their small size and frail health, the slightest loss of blood can cause serious anemia in neonates, particularly low birth weight infants. Our neonatal intensive care unit is proficient in the use of medications to encourage the production of red blood cells. In addition, blood collection for lab tests is kept to an absolute minimum. A new device being used in the intensive care unit runs the blood sample through a closed system: the blood is drawn through a catheter, runs through a sensor where it is tested, and then is returned to the patient. With this system, no blood is lost through laboratory testing.

Neurosurgery

New non-invasive and minimally-invasive techniques are being utilized to treat a wide variety of neurosurgical disorders, including brain tumors, venous malformations, and herniated disks. These techniques result in a much lower risk of bleeding and a faster recovery time. When conventional surgery is required, precise localization of tumors is made possible through the latest-generation of computer-guided imaging studies. This reduces the risk of damage to healthy tissue and minimizes blood loss.

Oral/Maxillofacial Surgery

This form of surgery is not often thought of as having a high potential for blood loss, but this is not the case. Bones have a steady blood supply and in the area of the face, bleeding is more difficult to control because a tourniquet cannot be applied to stop blood flow to the operative area. Meticulous technique and years of experience make it possible for University Center For Bloodless Surgery And Medicine surgeons to successfully perform these procedures without blood.

Orthopaedic Surgery

The University Center For Bloodless Surgery And Medicine performs hand surgery, knee replacement, hip replacement, orthopaedic trauma and more without the use of blood and blood products. Use of meticulous operative technique, tourniquets, maximizing the patient’s own blood supply prior to surgery, and the use of a cell-saver, when appropriate, are some of the techniques used to minimize blood loss during surgery and post-operative anemia.

Pediatric Surgery

Transfusion-free care can be safely applied to infants and children, utilizing the same techniques that are applied to adults. However, extensive experience in pediatric management and medication dosing are critical to the safe application of bloodless care. The pediatric surgeons at the University Center For Bloodless Surgery And Medicine are committed to exploring and utilizing all relevant non-blood techniques and options.

Trauma Surgery

Trauma care requires quick and decisive action. Nonetheless, the wishes of patients who have been identified as choosing to refuse blood transfusions can be honored at the same time that immediate interventions are taken. First, the source of bleeding must be identified and repaired as soon as possible. Blood lost can be reinfused in a continuous loop. Cell savers can provide quick salvage and gentle reinfusion. Arterial embolization is a technique that can stop the hemorrhaging that occurs with trauma.

Vascular Surgery

Aneurysm surgery comes with a high risk of blood loss. In some cases, a new minimally invasive technique, endovascular grafting, can be performed. Using a modified method of CT scanning, a picture of the inside blood flow through the artery is produced. This allows the surgeon to have a clear picture of the surgical area before an incision is made. This advancement makes it possible to avoid areas that have more blood vessels and choose the safest approach for surgery.

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