# Bloodless Gynecological Surgery in Blood Products Refusing Patients: Experience of a Single Institution

## TL;DR

This study explores bloodless gynecological surgery for patients who refuse blood products, using various strategies to manage hemoglobin levels effectively.

## Contribution

The study contributes a single-institution experience on implementing bloodless surgery strategies in gynecological procedures.

## Key findings

- No significant differences were found between patients receiving preoperative supplements and those who did not.
- Bloodless surgery procedures helped maintain hemoglobin levels even in critical situations.
- Further research is needed to clarify the effectiveness of bloodless surgery in gynecological patients.

## Abstract

This pilot study aimed to apply the central tenets of bloodless surgery and to analyze the effectiveness of specific preoperative, intraoperative, and postoperative strategies to minimize the risk for blood transfusion after gynecological surgery in a specific group of patients who refused blood products.

A total of 83 patients undergoing gynecological surgery were included in the study. Forty-two patients received preoperatively oral iron, acid folic, and vitamin B12 supplementation in the 30 days before surgery, and 41 patients did not receive therapy.

No significant differences were found when comparing the two study groups. The implementation of all procedures to maintain a bloodless surgery has been helpful, in association with the other available procedures, in achieving optimal management and maintenance of hemoglobin levels, even in the most critical situations.

In conclusion, implementing the bloodless approach as much as possible could guarantee the patient better and safer clinical and care management. Furthermore, well-designed research is required to clarify further the effects of bloodless surgery in gynecological patients.