The Effect of Acute Anemia and Iron Deficiency Anemia on Wound Healing

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Abstract
The "clinical impression" of many surgeons is that wounds heal better if the hematocrit is maintained at a normal level. However, a normal level for wound healing, below which healing is impaired, has not been defined. During a year of postoperative care of servicemen in Vietnam, my colleagues and I arbitrarily set the transition level at a hematocrit of 30% and transfused only if the hematocrit was below that level. We were motivated by the knowledge that healthy adults with normal iron stores could raise their hemoglobin 0.25 gm/100 cc/day1 and by the very real dangers of unnecessary transfusions, ie, hepatitis, incompatibility reaction, and the added load to the kidneys of clearing the breakdown products of old blood. With the known increase of the relative viscosity of blood with an increase in hematocrit,2 it was considered possible that small vessel perfusion was actually improved by limiting transfusion. We

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