Bloodless surgery refers to use of no donated blood during and after the surgery. However, blood transfusion can be life saving. People refuse blood transfusion for many reasons, Jehovah's Witnesses reject blood transfusions on religious grounds.
Bloodless surgery starts before the actual procedure. In preparation for bloodless surgery, blood levels can be increased with the use of iron and erythropoietin hormone. In patients with low hemoglobin level, anemia, it is important to identify the cause of anemia and treat it before surgery.
In surgery, control of bleeding is meticulously achieved and when feasible minimally invasive surgical techniques are used. Instead of donated blood, blood substitutes maybe used. During bloodless surgery, the blood from the patient is collected and is given back to the patient, this technique is called blood salvage or cell saver technique. In some cases, patients may also donate their blood for use during the surgery.
An example of minimally invasive technique for bloodless surgery is to use the off-pump coronary artery bypass surgery, this technique has been proven to reduce blood transfusion.
After the surgery, phlebotomy is minimized, and when necessary “pediatric tubes” are employed. If needed, iron and erythropoietin therapy is re-initiated.
Care of patients undergoing bloodless surgery requires multidisciplinary approach, this means doctors from different specialties develop a plan to help in caring for patients before and after surgery.