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Guideline for craniofacial & neurosurgical pre-operative blood product ordering RHC

What's New

14/12/2022 Minor changes: additional blood products are being used for total calvarial vault remodelling which reflects change in surgical technique.


Standardisation of the blood product ordering for craniofacial and neurosurgical cases.


Children requiring craniofacial and neurosurgical surgery. 


Healthcare professionals involved in the pre-operative management of these children.


Blood products to be ordered

Monobloc advancement

4 units RCC
20ml/kg FFP
10ml/kg platelets

Total calvarial vault remodelling (for correction of scaphocephaly)

2 units RCC
20mls/kg FFP
10mls/kg platelets

Other synostosis repair including; Tigonocephaly, Brachycephaly, Plagiocephaly, Fronto-orbital advancement

2 units RCC

Dermoid cyst

1 unit RCC

Vault expansion

1 unit RCC

Craniotomy for


1 unit RCC

Tumour resection/debulking

2 units RCC


2 units RCC

Cyst fenestration

1 unit RCC

RCC: Red Cell Concentrate

FFP: Fresh Frozen Plasma

Cryo: Cryoprecipitate

This list is not exhaustive. Other procedures assessed on a case to case basis, please discuss with the anaesthetist for the case.

Emergency use Group O negative blood is always available in Theatre fridge if blood is needed urgently

Editorial Information

Last reviewed: 20 November 2022

Next review: 30 November 2025

Author(s): J Erskine

Version: 2

Author Email(s):

Co-Author(s): D Roger, A Kreslins, P Bolton, E Harrison (2015 version)

Approved By: Anaesthetics Dept; Neurosurgery/Craniofacial Service