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Rush Medical Laboratories
Maximum Surgical Blood Order Schedule (MSBOS)

MSBOS is a list of common elective surgical procedures performed with a maximum number of units of blood being crossmatched preoperatively for each procedure. The purpose is to decrease excessive crossmatching that may result in increased blood outdating and unnecessary charges to the patient, and to provide more efficient blood utilization.

Common Surgeries:

MAXIMUM SURGICAL BLOOD ORDER SCHEDULE

CARDIOVASCULAR-THORACIC SURGERY

# units crossmatched, TS = type and screen, "-" = no TS or crossmatch

AICD

TS

Aortic bifurcation graft (aneurysm or aortobifemoral graft)

2

Axillary femoral, axillary bifemoral bypass

TS

CABG

2

CABG redo

4

Carotid enclarterectomy

TS

Closed pediatric heart surgery

1

Congenital heart surgery

3

Femoral popliteal bypass

TS

Mitral or aortic valve replacement

2

Mitral or aortic valve replacement redo

4

Pacemaker implantation

TS

Thoracic aortic aneurysm resection

4

Vein ligation

TS

ENT

# units crossmatched, TS = type and screen, "-" = no TS or crossmatch

Arytenoidectomy

TS

Cleft lip or palate repair

TS

Excision, branchial cleft, or thyroglossal duct cyst

TS

Excision nasopharyngeal angiofibroma

4

Exploration of laryngeal fracture

TS

External ethmoidectomy

TS

Hemilaryngectomy or total laryngectomy

TS

Lateral rhinotomy

1

Major temporomandibular arthrotomy

2

Maxillary or mandibular osteotomy, fracture repair or reconstruction

2

Neck dissection (all types)

TS

Osteoplastic frontal sinusectomy

TS

Partial glossectomy

2

Partial maxillectomy

1

Partial parotidectomy

TS

Radical maxillectomy

2

Submaxillary gland excision

TS

Submucous resection, septoplasty

TS

Supraglottic laryngectomy and radical neck dissection

2

Temporomandibular arthroscopy/arthrotomy

TS

Thyroidectomy

TS

Thyrotomy (laryngofissure)

TS

Total laryngectomy and radical neck dissection

2

Total parotidectomy

TS

Tracheostomy

-

GENERAL SURGERY

# units crossmatched, TS = type and screen, "-" = no TS or crossmatch

Abdominal lipectomy

TS

Abdominoperineal resection

3

Adrenalectomy

2

Appendectomy

TS

Augmentation mammoplasty

-

Axillary or groin dissection

TS

Cadaver renal transplant

TS

Cholecystectomy with/without CD exploration

TS

Colostomy or colostomy closure

TS

Colon resection

2

Common duct revision or reconstruction

2

Construction of ileal pouch/ileoanal reconstruction

3

Cutaneous or myocutaneous flap

TS

Esophageal diverticulectomy

TS

Excision, branchial cleft, or thyroglossal duct cyst

TS

Excision retroperitoneal mass

2

Exploratory laparotomy, emergency

2

Gastric resection

2

Hemorrhoidectomy

TS

Hepatic resection

4

Hernia repair

-

Live donor nephrectomy

TS

Liver transplant

20

Major pancreatic resection

4

Mastectomy

TS

Muscle group excision

2

Neck dissection (all types)

TS

Operations for GE reflux

TS

Pancreatic drainage procedure

2

Parathyroidectomy

TS

Partial glossectomy

2

Partial parotidectomy

TS

Pelvic node dissection

2

Polypectomy (open), benign tumor

TS

Rectal procedures

-

Reduction mammoplasty, mastoplexy, or breast reconstruction

TS

Skin graft

TS

Small bowel resection

TS

Sphincteroplasty

2

Splenectomy

TS

Submaxillary gland excision

TS

Total paroticlectomy

TS

Thyroidectomy

TS

Vagotomy and drainage

TS

Wide excision of skin and soft tissue

TS

NEUROSURGERY

# units crossmatched, TS = type and screen, "-" = no TS or crossmatch

Adult craniotomy (tumor/aneurysm/AVM/seizure/abscess)

4

Aneurysm and arteriovenous malformation repair

2

Anterior cervical fusion/excision of lumbar disc

TS

Any major craniotomy or laminectomy in a child younger than 5 years

4

Burr holes for subdural hematoma

2

Cranioplasty or craniosynostosis repair

4

Craniotomy for subdur~l hernatoma

2

Depressive lumbar/cervical larninectomy

2

Excision of brain or spinal cord tumor, primary or metastatic

2

Peripheral nerve repair

TS

Transphenoidal hypophysectomy

2

Temporal bone resection

3

Ventriculoperitoneal shunt (shunt placement) (child)

TS

OBSTETRICS/GYNECOLOGY

# units crossmatched, TS = type and screen, "-" = no TS or crossmatch

Cervical conization

-

Cesarean section (uncomplicated)

TS

Cystectomy - ovarian

TS

D & C

-

Exploration for ovarian cancer

2

Exploratory laparotomy - emergency

2

Laparoscopy diagnostic

TS

Laparoscopy operative

TS

Local perineal procedures

TS

Pelvic exenteration

4

Radical hysterectomy

2

Stress urinary incontinence repair

TS

TAH with/without BSO

TS

Tubal ligation

-

Uterine myomectomy

TS

Vaginal hysterectomy

TS

Vulvectomy

2

OPHTHALMOLOGY

# units crossmatched, TS = type and screen, "-" = no TS or crossmatch

Orbital exenteration

-

ORTHOPEDICS

# units crossmatched, TS = type and screen, "-" = no TS or crossmatch

All foot surgery

TS

All hand surgery

TS

Amputation above or below elbow

TS

Amputation, disarticulation or forequarter

4

Arthroscopy or arthroscopic surgery

-

Ender nail-up or femur

TS

Forearm operations

2

Hindquarter amputations

4

Humerus, open reduction or excision of a bony lesion or bone graft

2

Intravertebral disc excision

2

Knee ligament reconstruction

TS

Lower extremity amputations

TS

Open reduction, ankle or tibia

TS

Open reduction, femur or intertrochanteric fracture

2

Replacement, femoral head or total hip

2

Revision total hip arthroplasty

4

Shoulder reconstruction

2

Spinal arthrodesis with instrumentation for scoliosis

4

Spinal fusion, lumbar

2

Total knee replacement

2

PLASTIC SURGERY

# units crossmatched, TS = type and screen, "-" = no TS or crossmatch

Abdominal lipectomy

TS

Augmentation mammoplasty

-

Cleft lip or palate repair

TS

Cutaneous or myocutaneous flap

TS

Debridement and closure of pressure (muscle group excision)

2

Facelift

TS

Free flap

2

Major craniofacial reconstruction or fracture repair

4

Reduction mammoplasty, mastoplexy, or breast reconstruction

TS

Rhinoplasty

TS

Skin graft

TS

Wide excision of skin and soft tissue

TS

UROLOGY

# units crossmatched, TS = type and screen, "-" = no TS or crossmatch

Cystectomy

2

Excision scrotum (complete or partial)

TS

Nephrectomy

2

Orchiectomy

TS

Prostatectomy (open)

2

Transurethral resection, prostate or bladder

TS

Urethroplasty

TS

Urinary diversion

2



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