Blood bank unit department of pathology hospital umum sarawak



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MAXIMUM SURGICAL BLOOD ORDERING SCHEDULE (MSBOS)

SECOND EDITION

2015

BLOOD BANK UNIT

DEPARTMENT OF PATHOLOGY

HOSPITAL UMUM SARAWAK

Contents

Page

1.0 Obstetric and Gynaecology

1.1 Gynaecology Surgery 1

1.2 Obstetric Surgery 2


2.0 Surgery

2.1 General Surgery 3 - 4

2.2 Neurosurgery 4

2.3 Urosurgery 4

2.4 Plastic Surgery 5-6

2.5 Cardiothorasic Surgery 6

2.6 Paediatric Surgery 7

2.7 Ophtalmological Surgery 7

2.8 Ear, Nose & Throat (ENT) Surgery 7-8

2.9 Oral & Maxillofacial Surgery 9


3.0 Orthopaedic Surgery 11-12
4.0 Miscellaneous 13
Abbreviations 14


1. OBSTETRIC & GYNAECOLOGY
HUS/ BB/ MSBOS 15


RECOMMENDATION

(Units of blood)

1.1 GYNAECOLOGY SURGERY


  1. Abdominal :

-Radical hysterectomy (Wertheim)

-Extending hysterectomy

-Debulking surgery with gross ascites

-Complicated/difficult hysterectomy

-Simple hysterectomy

-Myomectomy

-Cystectomy/Oopherectomy

-Exploratory laporatomy

-Adhesiolysis

-Burch Colposuspension

-Vault Suspension

-Salpingectomy for non bleeding ectopic pregnancy

-Salpingectomy for bleeding ectopic pregnancy

-Tubal sterilization

-TVT/TVTO
2. Laparoscopic:

-Diagnostic Laparoscopy & Dye Insufflation

-Laparoscopic tubal ligation

-Laparoscopic adhesionlysis

-Laparoscopic cyst aspiration

-Laparoscopic cystectomy/oopherectomy

-Laparoscopic assisted vaginal hysterectomy

-Total laparoscopic hysterectomy


3. Vaginal:

-Vulvectomy with lymph nodes sampling

-Vaginal hysterectomy & pelvic floor repair

-Le fort operation

-I & D of vulva hematoma

-Vulva biopsy

-Pelvic floor repair

-Vaginal reconstruction

-Marsupialisation

-Hymenectomy

-Cold knife cone biopsy

-LLETZ


-Excision of cervical fibroid

-Cervical circlage

-EUA, staging, cystoscopy and cervical biopsy

4

4



4

4

2

2-4


GSH

2

GSH


GSH

GSH


GSH

4

-

GSH



-

-

GSH



-

GSH


2

4

2

2

-

GSH


-

GSH

GSH


-

-

GSH



-

GSH


-

-


1


1. OBSTETRIC & GYNAECOLOGY

RECOMMENDATION

(Units of blood)

-Polypectomy

-Suction & curettage FOR MOLAR PREGNANCY



<20 WEEKS SIZE

>20 WEEKS SIZE

-ERPOC


-EUA and DD&C

-Hysterscopy +/- endometrial biopsy

-Removal of IUCD


-
2

4

GSH


-

-

-



1.2 OBSTETRIC SURGERY
1. Lower Segment Caesarean Section (LSCS):

-Anemia Hb < 8.0g/dL

-Placenta praevia major with previous scar

-Placenta praevia major with no previous scar

-ANY PLACENTA PREVIA TYPE 4

-Abruptio placenta without coagulopathy

-Abruptio placenta with coagulopathy

-Severe pre-eclampsia/ eclampsia with

coagulopathy

-Obstructed labour

Others: Fetal distress

Cord prolapsed

Abnormal Presentation

Failed Induction

Breech

CPD


Poor progress

>2 previous scars

Twin pregnancy



  1. Classical Caesarean Section

  2. Caesarean hysterectomy

  3. Post-partum hysterectomy

  4. Evacuation of vulva haematoma



2

4



4

4

2+/-DIVC Regime

4 + DIVC Regime

2 +DIVC Regime


2

GSH


GSH

GSH


GSH

GSH


GSH

GSH


2

GSH
2

4 + DIVC Regime

4 + DIVC Regime

2



HUS/ BB/ MSBOS 15

2


MAXIMUM SURGICAL BLOOD ORDERING SCHEDULE (MSBOS) – FOR HOSPITAL UMUM SARAWAK - 2015

2. SURGERY

RECOMMENDATION

(Units of blood)

2.1 GENERAL SURGERY


  1. Gastric:

-Total gastrectomy

-Partial gastrectomy



  1. Liver:

-Left lateral segment resection

-Resection

-Biopsy


  1. Biliary:

-Cholecystectomy: Elective

Emergency



  1. Bowel:

-Small gut resection

-Large gut resection

-AP resection

-Whipple’s

-Appendicectomy

-Colostomy

5. Head & neck:

-Parotidectomy

-Hemithyroidectomy : For lump

-Thyroidectomy: Large

-Lumps

6. Breast:



-Mastectomy : Simple

Patey’s/ radical

-Lumps


  1. Vascular:

-Embolectomy: Femoral

-Aortic aneurysms : Elective



  1. Others:

-Amputation : Below knee

: Above knee

-Abscess

-Carbuncle: Saucerisation

-Laparotomy : Planned

Repeat/ gut resection

Traumatic bleeding

Emergency

-Splenectomy : Elective

4

2


4

4

GSH


GSH

2
2

2

4

4



-

-
GSH

GSH

2

-


GSH

2

-


2

6
GSH

2

-

GSH



GSH

2

4



2

2



HUS/ BB/ MSBOS 15

3




2. SURGERY

RECOMMENDATION

(Units of blood)

-Herniorrhaphy/herniotomy

-Mayo’s repair: large hernia

-Heamorrhoidectomy

-Anal cutback




-

GSH


-

-


2.2 NEUROSURGERY
1. Cranioplasty

2. Burr hole in chronic subdural haematoma

3. VP Shunt

4. Craniotomy for tumour

5. Craniotomy for AVM/ aneurysm

6. Transphenoidal for pituitary adenoma

7. Spine operations:

-Omectomy cervical

-Fusion and directom

-Tumour


-Lumbar minidisecty


GSH


2

2

4

4-6

4
4

4

4

2

2.3 UROSURGERY


  1. Urology:

-Pyelolithotomy : Simple

:Extended

-Nephrolithotomy

-Nephrolithotomy-anatropic

-Nephrectomy

-PCNL


-TURP/TURBT : Small

: Bulky


-Prostectomy: Robotic

-Cystectomy

-Vesicolithotomy

-Orchidopexy



GSH


2

2

4



4

4

GSH


2

2

4



GSH

-



HUS/ BB/ MSBOS 15

4




2. SURGERY

RECOMMENDATION

(Units of blood)

2.4 PLASTIC SURGERY
1. Craniofacial surgery :

- Surgery of nasal encephalocoele

2. Free tissue transfer

3. Head & neck malignancy with radical neck dissection

4. Facial trauma (Emergency) :

- Very severe

- Tear of maxillary artery

5. Excision of benign / malignant lesion with flap

coverage

6. Partial glossectomy with radical block dissection of

neck

7. Total glossectomy with / without neck dissection



8. Tongue flaps

9. Malignant lesion with reconstruction of oral cavity

10. Head & neck malignancy excision including bone

reconstruction

11. Mandible :

- Removal of adamantinosis

- Cyst removal

12. Reconstruction of facial fractures (very severe)

13. Reconstruction of facial injury soft tissues (very

severe)


14. Reduction of fibrous – dysplasia

15. Repair of trachea-cutaneous fistula

16. Burns (very severe)

17. Px of sequelae (very severe) :

- Release of contracture & joint

18. Breast :

- Augmentation

- Reduction

- Ptosis correction

19. Myo & Osteomyo cutaneous

20. Rib graft removal

21. Hand reconstruction with soft/bony injury (very

severe)

22. Bladder reconstruction



23. Vaginal reconstruction

24. Radical vulvectomy

25. Reconstruction of naevi including congenital/giant

hairy naevus (very severe)

26. Rhytidectomy

6

2



4
4

6

4


3-4
4

2

2

2



GSH

GSH


4

GSH
GSH

-

4-6
GSH
-

GSH


-

4

-

GSH


4

GSH


4

GSH
-





HUS/ BB/ MSBOS 15

5




2. SURGERY

RECOMMENDATION

(Units of blood)

27. Abdominoplasty

28. Reconstructive surgery of haemangioma (very

severe)


29. Reconstructive surgery of lymphangioma

30. Reconstructive surgery of AV malformation

31. Excision of benign / malignant lesion with primary

closure


32. Burns with flaps closure

33. Burns with skin grafts (scalp)

34. Exenteration of orbit

35. Leukoplakia excision & grafting-mouth (severe)

36. Cleft palate :

- Children

- Adults

37. Pharyngoplasty

38. Partial glossectomy

39. Oral cavity – Benign / malignant lesion excision with

primary closure

40. Split Skin Grafting (SSG) – severe

41. Bone grafting

GSH


6
4

6

-
GSH

2

GSH


GSH
GSH

GSH


-

2

-


4-6

-


2.5 CARDIOTHORACIC SURGERY


  1. Thoracic:

-Thoracotomy: Decortication

-Lobectomy

-Pneumonectomy

-OGDS: Sclerotherapy


2. Cardiac :

- CABG


- CABG : Redo

- Valve surgery : single

: double
3. Paeds cardiac surgery



2-4

2-4

2-4

2

2-4

4, FFP

2

4


100 ml (Aliquots)



HUS/ BB/ MSBOS 15

6




2. SURGERY

RECOMMENDATION

(Units of blood)

2.6 PAEDIATRIC SURGERY


  1. Major operation involving the thorax & abdomen :

- Neonatal

- Others



  1. Liver resection

- Hemangiomatous malformation

  1. Minor surgery

- Hernia

- Hydrocele

- Undescended testis

- Hypospadias repair


100 mls


200 mls

4 (of 250 mls pack)

-

-



-

-


2.7 OPHTALMOLOGICAL SURGERY


  1. Retinoblastoma

  2. Orbital Tumour

  3. Dacryocystorhinostomy

GSH


GSH

GSH



2.8 EAR, NOSE & THROAT (ENT) SURGERY
1. Adenoidectomy

2. Adenotonsillectomy

3. Angiofibroma excision

4. Bronschscopy + biopsy

5. Caldwell Luc

6. Craniofacial resections / skull base tumors

7. Direct Laryngoscopy + Biopsy

8. Drainage of postauricular abscess

9. Drainage of retropharyngeal + parapharyngeal abscess

10. Elective microlarnygeal surgery

11. Endoscopic Nasopharyngectomy

12. Examination of nose or PNS under GA

13. Examination of ear under microscope

14. Examination under anaesthesia

15. Exisicion of pre-auricular sinus

16. Free Flap Reconstructions

17. Intranasal endoscopic ethmoidectomy


GSH


GSH

4-6


GSH

GSH


4

-

-



-

-

-



-

-

-



-

4

-





HUS/ BB/ MSBOS 08

7




2. SURGERY

RECOMMENDATION

(Units of blood)

18. Intranasal polypectomy for single polyp

19. Intranasal antrostomy

20. Laryngeal stenosis-repair

21. Larn yngectomy -total/partial

22. Lateral rhinotomy

23. Ligation of external carotid

24. Mastoidectomy- modified radical

25. Mastoidectomy-radical

26. Maxillectomy

27. Modified radical mastoidectomy

28. Myringoplasty

29. Myringptomy

30. Nasal polypectomy

31. Oesophagoscopy

32. Parotidectomy-complete/partial

33. Panendoscopy

34. Radical neck dissection

35. Removal of foreign bodies- ENT

36. Removal of submandibular salivary gland

37. Repair of laryngeal and tracheal stenosis

38. Rhinoplasty- augmentation/reduction/prosthesies

39. Septoplasty

40. Tonsillectomy

41. Total laryngopharyngectomy

42. Tracheal stenosis-repair

43. Tracheostomy

44. Tympanoplasty



-

-



-

4

4



-

-

2



-

-

-



-

-

-



2

-

4



-

-

-



-

-

GSH



4

-

-



-

Note :

Blood requirement may increase in cases of previously received radiotherapy.




HUS/ BB/ MSBOS 08

8




2. SURGERY

RECOMMENDATION

(Units of blood)

2.9 ORAL & MAXILLOFACIAL SURGERY
A) MINOR ORAL SURGERY

1. Removal of impacted & unerupted teeth

2. Incision biopsy

3. Aveolectomy

4. Apicectomy

5. Surgical removal of roots

6. Frenectomy

7. Excision of mucocele

8. Cervical lymph node biopsy

9. Localised periodontal flap

10. Repair of minor orofacial lacerations

11. Removal of salivary calculus

12. Removal of roots in antrum and closure of oroantral fistula

13. Sinus lift


B) MAXILLOFACIAL TRAUMA

a) Hard tissues

Open reduction & internal fixation:

- Orbital exploration & reconstruction

- Frontal sinus fracture

- Nasal fracture

- Maxillary & pan-facial fracture

- Mandibular fracture

- Condylar fracture

- Dentoalveolar fracture

- Zygomatic complex fracture
b) Soft tissues

1) Primary repair of soft tissue injury

2) Reconstruction of large hard & soft tissue loss of the face
C) ONCOLOGY

1) Excision of benign / malignant lesion with local /

non-vascularised flap

2) Partial glossectomy with radical block dissection of

neck

3) Glossectomy with / without neck dissection



4) Lip reconstruction with tongue flap

-

-



-

-

-



-

-

-



-

-

-



-

GSH


GSH

GSH


-

-

GSH



GSH

-

GSH



-

GSH


2
2-4
6

GSH



HUS/ BB/ MSBOS 08

9




2. SURGERY

RECOMMENDATION

(Units of blood)

D) ORTHONAGTHIC SURGERY

1) Bimaxillary osteotomy

2) Sagittal split mandibular osteotomy

3) Genioplasty
E) Repair of cleft lip and cleft palate

F) Alveolar bone grafting

G) Temporomandibular joint surgery

H) Surgical correction of development jaw deformity

I) Preprosthetic surgery

J) Dental implants with / without bone grafting

K) Sinus lift surgery

L) Excision of haemangioma (depends on the size)

M) AV malformation

N) Surgery of salivary glands

O) Management of severe infection of the jaw with

surgery


  1. Enucleation or marsupialization of cysts of the jaw


2

GSH



-
-

-

-



2-4

-

-



GSH

GSH


2-4

-

-


2




HUS/ BB/ MSBOS 15

10


MAXIMUM SURGICAL BLOOD ORDERING SCHEDULE (MSBOS) – FOR HOSPITAL UMUM SARAWAK - 2015

3. ORTHPAEDIC SURGERY

RECOMMENDATION

(Units of blood)




  1. Spine:

- Cervical Spine : Posterior fusion

: Anterior fusion

: TB of cervical spine

- Thoracic & Lumbar : a. Anterior Procedure Fusion



  • TB spine / malignancy

  • Spinal fracture

  • Scoliosis

  • Degenerative disease

b. Posterior Procedure

Degenerative disease of spine



  • Dissectomy fenestration

  • Laminectomy

  • Posterior fusion

c. Scoliosis Instrumentation

d. Fracture Stabilisation


2. Shoulder :

- Shoulder arthroplasty

- Open surgery to shoulder joint

- Fracture proximal humerus

- Forequarter amputation
3. Arm & Forearm :

- Fixation of humeral shaft

- Elbow arthroplasty

- Other operation at / below the elbow


4. Hip & Pelvis :

- Total Hip Replacement (THR)

- Hemiarthroplasty

- Fracture acetabulum fixation

- Proximal femoral tract fixation : DHS

- Hip fusion

- Hip disarticulation

- Hindquarter amputation

- CDH : Open reduction / osteotomy

- Pelvic osteotomy





4

4

4
4


4

6

4


2-4

4

4

6

4


2

2

GSH



4

2

GSH


-

2-4

2

4



2

2

4



4

2

4






HUS/ BB/ MSBOS 08

11




3. ORTHPAEDIC SURGERY

RECOMMENDATION

(Units of blood)

5. Thigh & Knee

- Open : K nail / plating

- Closed : ILN / antegrade K nail

- Femoral / tibial condyle fracture fixation

- Tibial spine fracture fixation

- Arthroscopy / menisectomy

- Knee ligament reconstruction

- Total knee replacement (TKR)

- Tibial osteotomy

- Patellar procedure

- Above knee amputation (AKA)


6. Leg & Foot :

- Tibial shaft fracture

- Non union tibial

- Below knee amputation (BKA)

- Procedure at ankle & Foot
7. Tumor surgery :

- Open biopsy


- Tumor excision / reconstruction :

a. Pelvis

b. Proximal femur

c. Thigh

d. Knee


e. Upper limb ~ Humerus

~ Shoulder

~ Below elbow
8. Miscellaneous :

- Bone graft harvesting from ilium

- Extensive burn / soft tissue debridement

- Flap surgery for wound coverage (depends on the

sites)


2

GSH



GSH

-

-



-

2

GSH



-

2-4

GSH


GSH

2

-



Depends on site & anatomy of procedure.

6

6



6

6

6



6

4

GSH



2-4

GSH


HUS/ BB/ MSBOS 15

12


MAXIMUM SURGICAL BLOOD ORDERING SCHEDULE (MSBOS) – FOR HOSPITAL UMUM SARAWAK - 2015

4. MISCELLANEOUS

RECOMMENDATION

(Units of blood)

1. Cardiac catheterisation

2. Coronary angiogram

3. Pacemaker insertion





2

GSH

GSH




HUS/ BB/ MSBOS 15

13


ABBREVIATIONS

AAA (Triple A) ~ Abdominal Aortic Aneurysm

AKA ~ Above Knee Amputation

AP ~ Anterior –Posterior

AV ~ Arteriovenous

BKA ~ Below Knee Amputation

BTL ~ Bilateral Tubal Ligation

CPD ~ Cephalo Pelvic Disproportion

D&C ~ Dilatation & Currettage

DD&C ~ Diagnostic Dilatation & Currettage

DHF ~ Dengue Haemorrhagic Fever

DHS ~ Dynamic Hip Screw

DIVC ~ Disseminated Intravascular Coagulation

ERPOC ~ Evacuation of Retain Products of Conception

ET ~ Exchange of Transfusion

ENT ~ Ear, Nose & Throat

EUA ~ Examination Under Anaesthesia

GA ~ General Anaesthesia

I&D ~ Incision & Drainage

ILN ~ Interlocking Nail

IMN ~ Intramedullary Nailing

IOL ~ Induction of Labour

IUCD ~ Intra Uterine Contraception Device

LAVH/LVH ~ Laparoscopic Approach Vaginal Hysterectomy

LLETZ ~ Large Loop Excision of Transitional Zone

LSCS ~ Lower Segment Caesarean Section

OGDS ~ Oesophagogastroduodenoscopy

PCNL ~ Percutaneous Nephrolithotomy

PNS ~

PP ~ Placenta Praevia



SSG ~ Split Skin Grafting

TAH ~ Total Abdominal Hysterectomy

TAHBSO ~ Total Abdominal Hysterectomy with Bilateral Salpingoophorectomy

TB ~ Tuberculosis

THR ~ Total Hip Replacement

TKR ~ Total Knee Replacement

TURBT ~ Transurethral Resection of Bladder Tumour

TURP ~ Transurethral Resection of the Prostate

TVT / TVTO ~ Tension Free Vaginal Tape

VP ~ Ventriculoperitoneal


HUS/ BB/ MSBOS 15

14



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