Routine Preoperative Typing and Screening: A Safeguard or a Misuse of Resources

OBJECTIVE: To assess the necessity of routine preoperative type and screen testing before a cholecystectomy, hernia repair, or appendectomy based on the risk of transfusion in our department. METHOD: We conducted a retrospective analysis of the surgical database of patients who underwent a cholecystectomy, a hernia repair, or an appendectomy at Maimonides Medical Center over a 2-year period and examined the number of patients who actually received transfusions either on the day of surgery or on postoperative day 1. RESULT: We examined 3424 patients who underwent a cholecystectomy, hernia repair, or appendectomy over a 2-year period and examined how many patients required an RBC transfusion on the day of surgery or on postoperative day 1. Of our 3424 patients, 11 required a transfusion (1 appendectomy, 5 cholecystectomy, and 5 hernia repair) in the aforementioned time frame. Consequently, the risk of undergoing a transfusion in this perioperative period is 0.32%. CONCLUSION: With this low probability of requiring blood products during or immediately after surgery, our data and supporting literature firmly support the elimination of the routine type and screens before cholecystectomy, hernia repair, and appendectomy without diminishing the quality of patient care.