Blood Substitutes Used in Dentistry and OMFS: Systematic Review

Perioperative blood loss during dental and oral and maxillofacial surgical (OMFS) procedures often necessitates red blood cell (RBC) transfusion. However, associated risks, cost, and supply limitations have prompted the exploration of alternatives and evidence-based transfusion strategies. A systematic search was performed in PubMed, Scopus, and Web of Science using PRISMA guidelines. Studies were included if they focused on RBC transfusion or alternatives in surgical settings with relevance to OMFS. Data were extracted on study design, findings, and applicability to dental surgery. Fifteen studies met the inclusion criteria. These included guidelines, reviews, randomized trials, and observational studies. Key findings emphasized the benefits of restrictive transfusion thresholds, preoperative anemia management, intraoperative cell salvage, and adjunct therapies like erythropoietin and antifibrinolytics. Complications, such as transfusion-related acute lung injury, immunomodulation, and procedural errors, were highlighted. Only one study directly addressed OMFS, though others offered applicable insights. Emerging practices in transfusion medicine can enhance safety and efficacy in OMFS. Adoption of patient blood management strategies and transfusion alternatives should be prioritized in dental surgical planning.