Cross-match requirements in head and neck surgery

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Abstract
An audit of blood-ordering practices was carried out to compare the number of units of blood cross-matched and the number transfused during elective head and neck surgery. Routine cross-matching of blood for laryngectomy or radical neck dissection was found to be unnecessary, and it is suggested that a preoperative policy of blood grouping, screening for irregular antibodies and saving patients'' serum be adopted. Should blood then be required, this procedure enables un-crossmatched ABO-Rh(D) group specific blood to be released in an emergency with a high degree of safety. The routine cross-matching of blood can be supported for the remainder of the major head and neck operations, and guidelines as to the number of units that should be cross-matched are suggested. Implementation of these policies will reduce the number of units of blood unnecessarily cross-matched, decrease the amount of time-expired blood, and lead to increased efficiency of blood utilization.