LAUSR

Abdominal Wall Repair (AWR) is a surgical procedure with a risk of bleeding during and after its performance. Patients who reject blood transfusion require strategies to avoid bleeding or to increase the margin of indication for transfusion. We analyzed the Jehovah's Witnesses patients who underwent AWR in our hospital and the perioperative management aiming to prevent fatal anemia and allow the performance of the surgery in this group of patients. We present three Jehovah's Witnesses patients undergoing AWR for multirecurrent midline incisional hernias. All of them attended hematology consultation prior to surgery to improve their situation at the time of surgery. During surgery, hemostatic material was used in areas at risk of subsequent bleeding. All received iron after surgery and, prior to hospital discharge, a dose of erythropoietin if needed. Patient characteristics are presented in the table. No bleeding requiring blood transfusion or other complications occurred. Follow-up in outpatient clinics showed a correct evolution. Multidisciplinary care and particular attention to avoid bleeding and improve the condition of patients with refusal of blood transfusion makes complex abdominal wall surgery feasible and safer.