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Background <p>Cranial neurosurgical procedures often result in significant blood loss, particularly in conditions such as brain tumors, traumatic brain injury (TBI), and hemorrhagic stroke. Accurate estimation of blood loss is crucial for fluid management and prevention of complications during surgery.</p> Objectives <p>To compare intraoperative blood loss measured using the adhesive gutter drape technique (AGDT) versus the conventional draping method across three cranial neurosurgical indications—brain tumors, TBI, and hemorrhagic stroke—and to develop predictive models for blood loss based on operative duration using AGDT-derived measurements.</p> Methods <p>This cross-sectional comparative study included 216 adult patients (72 with brain tumors, 72 with TBI, 72 with hemorrhagic stroke). Draping methods were assigned using a systematic alternating sequence. Intraoperative blood loss was calculated as net suction volume after subtracting irrigation fluid. Independent t-tests compared blood loss between draping techniques. Predictive modeling used simple linear regression for each diagnostic category based on AGDT-derived measurements.</p> Results <p>AGDT consistently yielded higher and more complete measurements of blood loss than the conventional method across all diagnoses (brain tumors: 2550.0 ± 743.9 mL vs. 1188.9 ± 678.1 mL; TBI: 788.9 ± 381.6 mL vs. 419.4 ± 216.2 mL; hemorrhagic stroke: 650.0 ± 209.1 mL vs. 370.8 ± 150.4 mL; all <i>p</i> &lt; 0.0001). Operative duration was the strongest predictor of blood loss. Final regression models were: Brain tumors: <i>EBL = 1036.6 + 269.7 × duration (hours)</i> (<i>R²</i> = 0.641), TBI: <i>EBL = − 128.8 + 351.5 × duration (hours)</i> (<i>R²</i> = 0.413), Hemorrhagic stroke: <i>EBL = − 61.5 + 284.6 × duration (hours)</i> (<i>R²</i> = 0.688).</p> Conclusion <p>AGDT captures a substantially greater measurable volume of intraoperative blood loss compared with conventional draping. Operative duration is a significant predictor of blood loss across three major neurosurgical conditions. The derived regression equations may aid clinicians in preoperative planning, transfusion management, and intraoperative decision-making.</p>

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Improving intraoperative blood loss estimation in cranial neurosurgery: a draping-method comparison and predictive modeling using the adhesive gutter drape technique

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月30日

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  • Jebul Suroso,
  • Arif Yunianto,
  • Agus Santosa

摘要

Background

Cranial neurosurgical procedures often result in significant blood loss, particularly in conditions such as brain tumors, traumatic brain injury (TBI), and hemorrhagic stroke. Accurate estimation of blood loss is crucial for fluid management and prevention of complications during surgery.

Objectives

To compare intraoperative blood loss measured using the adhesive gutter drape technique (AGDT) versus the conventional draping method across three cranial neurosurgical indications—brain tumors, TBI, and hemorrhagic stroke—and to develop predictive models for blood loss based on operative duration using AGDT-derived measurements.

Methods

This cross-sectional comparative study included 216 adult patients (72 with brain tumors, 72 with TBI, 72 with hemorrhagic stroke). Draping methods were assigned using a systematic alternating sequence. Intraoperative blood loss was calculated as net suction volume after subtracting irrigation fluid. Independent t-tests compared blood loss between draping techniques. Predictive modeling used simple linear regression for each diagnostic category based on AGDT-derived measurements.

Results

AGDT consistently yielded higher and more complete measurements of blood loss than the conventional method across all diagnoses (brain tumors: 2550.0 ± 743.9 mL vs. 1188.9 ± 678.1 mL; TBI: 788.9 ± 381.6 mL vs. 419.4 ± 216.2 mL; hemorrhagic stroke: 650.0 ± 209.1 mL vs. 370.8 ± 150.4 mL; all p < 0.0001). Operative duration was the strongest predictor of blood loss. Final regression models were: Brain tumors: EBL = 1036.6 + 269.7 × duration (hours) (R² = 0.641), TBI: EBL = − 128.8 + 351.5 × duration (hours) (R² = 0.413), Hemorrhagic stroke: EBL = − 61.5 + 284.6 × duration (hours) (R² = 0.688).

Conclusion

AGDT captures a substantially greater measurable volume of intraoperative blood loss compared with conventional draping. Operative duration is a significant predictor of blood loss across three major neurosurgical conditions. The derived regression equations may aid clinicians in preoperative planning, transfusion management, and intraoperative decision-making.