Notes

Outline

Blood Conservation in Craniofacial Reconstructive Surgery Joseph H Piatt, Jr, MD, FAAP Section of Neurosurgery

Apert Syndrome 9 month old female Bilateral coronal synostosis with brachycephaly Midface hypoplasia Radiohumeral synostosis on right Syndactyly

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Treatment Strategy Calvarial reconstruction during infancy for brain growth as well as for cosmesis Digital reconstructions during developmental window in infancy Midface advancement later in childhood, ideally in adolescence.

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Blood Conservation Tactics Staging of reconstruction Delay of first stage Erythropoietin Hemodilution Activated Factor VII Toleration of low post-op Hb

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Hemoglobin (gm/dL)

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