Bloodless Medicine

Bloodless medicine has several benefits. It:  

• Reduces risks associated with blood transfusion: While a blood transfusion can be beneficial during medical procedures, it also comes with risks, such as ABO incompatibility (receiving the wrong blood type), immune suppression and infection.  
• Preserves blood supply: Since blood banks are struggling to keep up with supply and demand, it is crucial to preserve our blood supply. In addition, trauma situations often demand the need for this precious resource, as do many cancer treatments. 
• Delivers a gold standard of care: Bloodless medicine is now the gold standard of care endorsed by Joint Commission, AABB (formerly known as the American Association of Blood Bankers), the Society for the Advancement of Blood Management, American Society of Extracorporeal Technology (AmSECT) and the Choose Wisely Campaign.   

Many patients ask about the use of fractionated blood products, such as plasma. Fractionated blood products are generally safer than whole blood transfusions because they contain no DNA and nearly all go through a pasteurization process to remove contamination. However, some religious practices also prohibit the use of these products.  

Bloodless medicine techniques and tools make it possible to perform some of the most complicated surgeries – from joint replacement to heart bypass – with minimum blood loss and a lower likelihood of blood transfusion.  

Before Surgery

Prior to surgery, we use a number of methods and technology to boost a patient’s blood counts, including:  

• Anemia treatment: If the patient has anemia, we will provide the appropriate treatment – such as vitamins, iron or medications – to increase their blood counts.  
• Hyperbaric oxygen chamber: This delivers high concentrations of oxygen levels in the patient’s blood of both before and after surgery.  
• Interventional radiology: Imaging technology, such as CT, angiography, MRI and MRA, are used to diagnose and treat many diseases, rather than surgery. 
• Minimal phlebotomy: We use smaller tubes to allow for minimum blood draws and minimize blood tests as much as possible. 
• Synthetic erythropoietin: This man-made medication mimics the natural erythropoietin hormone by stimulating the patient's bone marrow to produce red blood cells. 
• Volume expanders (bloodless alternatives): Fluids are administered intravenously to increase blood volume. 

During and After Surgery

During and after surgery, we can use several methods to reduce blood loss:  

• Advanced hemostatics: These are medications that stop bleeding.  
• Argon beam coagulator: This device helps stop bleeding during surgery by sealing off blood vessels. 
• Damage control surgery: This approach is used in trauma patients to control bleeding during surgery.  
• Endoscopic surgery: This type of surgery is performed with tiny instruments to avoid large incisions and open procedures. 
• Harmonic scalpel: This tool simultaneously cuts and coagulates tissue during surgery to avoid blood loss. 
• Intraoperative blood cell recovery and reinfusion: During surgery, the team uses technology that collects as much of the patient’s lost blood as possible, cleans it and reinfuses it to the patient.  
• Intraoperative hemodilution: This is the process of diluting blood to reduce red blood cell loss.  
• Laser surgical techniques: These techniques help create a bloodless surgical field by cutting through the tissue with the energy that comes from light. 
• Platelet gel: This material is formed from the patient’s own blood and helps speed healing after surgery. 
• Quick trauma response: Our team assesses and treats traumatic injuries as quickly as possible to control bleeding.  
• Transcutaneous oximetry: Physicians can track oxygen levels in the skin during surgical procedures. 

Prior to surgery, your doctor will order blood tests to ensure your blood meets the threshold for bloodless medicine procedures. These tests may include: 

• Coagulation studies: To determine how well your blood clots.  
• Complete blood count: To determine if you have an infection or anemia (low red blood cells). 
• White blood cell count: To check for infection, fever or medication that may interfere with white blood cell count. 

To ensure that your healthcare wishes are respected, please complete the South Carolina Healthcare Power of Attorney form before your hospital visit.