New Method of Estimation of Blood Loss During Large-volume Liposuction and Lipoabdominoplasty.

Background: Liposuction and/or abdominoplasty is one of the most common procedures in plastic surgery. Safety is a primary concern for both patients and surgeons. In this study, we aimed to more accurately estimate perioperative blood loss to prevent and manage early decreases in hemoglobin percentage (HB%).

Methods: A prospective study was conducted between March 2022 and March 2024, involving 12 patients, both men and women, who underwent liposuction and/or abdominoplasty under general anesthesia. Samples were taken from aspirated fluid, fat, and drain, and a manual hematocrit calculation method was used. The volume of blood in the lipoaspirate was calculated based on the loss in the supernatant, fat, and drain fluids. Blood was replaced according to the study formula. Patients were assessed for postoperative decreases in HB% and stability of vital signs.

Results: The mean aspirate volume was 7400 mL, with a nontrivial volume of blood loss, and the mean postoperative decrease in HB% was 1.8 g/dL. After correcting for blood loss through transfusion according to the study formula, all patients were vitally stable, with no postural hypotension and normal pulse rates.

Conclusions: This study introduced a new method for intraoperative hematocrit calculation of blood loss in large-volume liposuction, allowing for accurate estimation of the volume of blood loss that may need to be replaced. This method improves the safety of the procedure, predicts postoperative decreases in HB%, and supports the decision to continue or halt the procedure safely.