Preoperative cross-matching in major head and neck surgery: a study of a department's current practice and eligibility for electronic cross-matching.

OBJECTIVE: The maximum surgical blood ordering schedule (MSBOS) has reduced but not eliminated the over-ordering and wastage of blood products. Electronic cross-matching (ECM) may be a suitable alternative method to provide blood on demand in eligible cases. The purpose of this study was to assess the department's current blood ordering policy and to identify patients eligible for ECM.

STUDY DESIGN: This was a retrospective observational study of 88 consecutive maxillofacial surgical oncology patients.

RESULTS: A total of 383 units of blood were cross-matched, of which 43% were not transfused. Of these, 38% were reallocated and 5% discarded. Of all cross-matched blood, 82% was eligible for ECM; 18% was not eligible, 6% because of the presence of antibodies and 12% because of lack of a second historical sample.

CONCLUSIONS: ECM is recommended as a safe method for elective surgery. Blood can be provided on demand, reducing workload and costs for transfusion services and minimizing wastage.