Blood should be treated respectfully
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《英国医生杂志》
EDITOR—Eaton passed on a useful reminder from the chief medical officer on the hazards of blood transfusion.1 Transfusions should be rare events in elective general surgery, and each event should be discussed at the next clinical meeting. Even in the case of operations as complex as oesophagogastrectomy and abdominoperineal resection of the rectum, transfusion can be avoided nine times out of 10. I also found that half the elective resections of abdominal aortic aneurysm could be safely done with a transfusion of 0-2 units.
The use of headlamp illumination, gentle saline irrigation, and when necessary magnification, provide optimal conditions for securing blood vessels before they are divided. The only problem is that operations take longer.
As an act of penitence I used to personally wipe away even a single drop of blood if spilt on the theatre floor, after completing the operation. It did not happen often but used to amuse the nurses, who no doubt sterilised the floor after I left.
I do not agree with the chief medical officer, however, that only consultants should order blood. Anyone with the membership of the Royal College of Surgeons or Royal College of Physicians is more than qualified to do this.
Roger H Armour, honorary consultant surgeon (retired)
Lister Hospital, Stevenage, Hertfordshire SG1 4AB roger@rharmour.fsnet.co.uk
Competing interests: None declared.
References
Eaton L. Chief medical officer warns that many blood transfusions are unnecessary. BMJ 2004;329: 308. (7 August.)
The use of headlamp illumination, gentle saline irrigation, and when necessary magnification, provide optimal conditions for securing blood vessels before they are divided. The only problem is that operations take longer.
As an act of penitence I used to personally wipe away even a single drop of blood if spilt on the theatre floor, after completing the operation. It did not happen often but used to amuse the nurses, who no doubt sterilised the floor after I left.
I do not agree with the chief medical officer, however, that only consultants should order blood. Anyone with the membership of the Royal College of Surgeons or Royal College of Physicians is more than qualified to do this.
Roger H Armour, honorary consultant surgeon (retired)
Lister Hospital, Stevenage, Hertfordshire SG1 4AB roger@rharmour.fsnet.co.uk
Competing interests: None declared.
References
Eaton L. Chief medical officer warns that many blood transfusions are unnecessary. BMJ 2004;329: 308. (7 August.)