Spine surgery and major blood loss: how accurate is suction canister estimation?

Purpose of the study This study aimed to estimate the proportion of intraoperative blood loss absorbed by gauze during major spine surgeries and identify factors influencing blood loss. Patients and methods A prospective cohort study of 28 patients undergoing elective major spine surgery with blood loss exceeding 1 L was conducted. Blood loss was estimated using the gravimetric method for gauze and measurement of suction canister contents. Demographic and surgical data were collected. Results On average, 21.19% of total blood loss was absorbed by surgical gauze. When considering blood loss in the suction canister, an additional 28.33% was absorbed by gauze. Two-column surgeries and longer surgical durations were associated with significantly higher total blood loss and suction-collected blood. No statistically significant differences were observed in the percentage of blood loss absorbed by gauze across most demographic and clinical factors. Conclusion This study provides insights into intraoperative blood loss distribution during major spine surgeries. Surgeons and anesthesiologists should add approximately 28% to the blood loss measured in the suction canister for a more accurate assessment. The findings can guide clinicians in anticipating blood loss and improving transfusion management, potentially leading to better patient outcomes.