Many strategies are important in minimizing blood transfusion during surgery, especially major surgery like cardiac, major (open) vascular, complex urology, obstetric and orthopaedic surgery. Important strategies include pre‐operative haemoglobin optimisation; bloodless surgery; the use of antifibrinolytics; blood conservation techniques; and evidence‐based transfusion triggers.
The current recommendations seek to widen availability and use of cell salvage where blood loss more than 10% of blood volume occurs. Whereas infection and cancer are not absolute contraindications, they recommend that the use of cell salvage in cancer surgery and infected fields should be considered on a case by case basis; leucodepletion filters should be used. Current evidence does not support the routine use of cell salvage during caesarean section.
Full review discussing the evidence, practice, risks and contraindications are in the review: