maximum surgical blood ordering schedule

Blood Bank and Transfusion Service
330 Mount Auburn Street
Cambridge, Massachusetts 02138
MSBOS
(Listing by Surgical Category)
MAXIMUM SURGICAL BLOOD ORDERING
SCHEDULE
Revised 12/01/09
# of RBC’s Crossmatched or Type & Screen
The Maximum Surgical Blood Order Schedule (MSBOS) has been developed
from an analysis of Red Blood Cell utilization by procedure. It has been
approved by the OR Executive Committee. The amount of Red Blood Cells
ordered by the surgeon should be an approximation of the anticipated need
based on the specific patient's condition. If the order will exceed the quantity
stated on the MSBOS, the surgeon must consult with the Blood Bank medical or
supervisory staff to arrange for an increase over the MSBOS. If a surgeon orders
fewer units than listed in the MSBOS, the lesser number will be prepared.
This document has been reviewed by the Blood Bank Medical Director and has
been adopted by the OR executive Committee.

MSBOS Alphabetical By Surgical Category Revised 12/01/09 Page 1 of 15 Pages
CARDIAC
PROCEDURE
MSBOS
Aneurysm, ascending aortic 4
Aneurysm, thoracic 8
Aneurysm, trans thoracic aortic 6
Aortic coarctation correction 2
Aortic valve replacement / repair (AVR) 4
Ascending aortic aneurysm 4
Atrial septal defect, uncomplicated 2
AVR (Aortic valve replacement) 4
AVR / CABG 4
AVR / MVR 4
AVR, re-do sternotomy 4
CABG (Coronary Artery Bypass Graft) 2
CABG / re-do sternotomy 4
Coronary angioplasty 4
Coronary Artery Bypass Graft (CABG) 2
Coronary vein graft (single/double/triple) 2
Coronary vein graft, re-operation 4
Double valve replacement (AVR / MVR) 4
Mitral valve replacement / repair (MVR) 2
MVR (Mitral valve replacement) 2
MVR / CABG 2
MVR / re-do sternotomy 4
Pacemaker change 0
Re-do AVR 4
Re-do CABG 4
Re-do MVR 4
Replacement, aortic valve 2
Replacement, mitral valve 2
Septal defect, atrial uncomplicated 2
Septal defect, ventricular 2
Thoracic aneurysm 8
Trans thoracic aortic aneurysm 6
Valve replacement, aortic 2
Valve replacement, double valve 4
Valve replacement, mitral 4

MSBOS Alphabetical By Surgical Category Revised 12/01/09 Page 2 of 15 Pages
ENT
PROCEDURE
MSBOS
Adenoidectomy 0
Caldwell luc (nasal septum) 0
Esophagoscopy 0
Ethmoidectomy
Excision, carotid body tumor 2
Extraction, single, multiple 0
Glossectomy
Jaw resection with neck, tongue dissection 2
Laforte osteotomy
T/S
Laryngectomy 2
Laryngectomy with radical neck dissection 2
Laryngectomy without node dissection 2
Laryngoscopy 0
Mandibulectomy
T/S
Myringotomy (paracentesis of tympanic membrane) 0
Nasal polypectomy 0
Nasal septum reconstruction 0
Neck dissection 2
Neck dissection, radical 2
Nose, open and closed reduction 0
Palate tumor
T/S
Parotid tumor, simple excision 0
Parotidectomy 0
Radical mastoidectomy 0
Simple mastoidectomy 0
Sinusotomy 0
Submucous resection (nasal septum) 0
Suturing postoperative tonsil and adenoid bleeding
Thyroglossal cyst 0
Tongue dissection with jaw resection 2
Tonsillectomy 0
Tumor of palate
T/S
Tympanotomy, exploratory 0
T/S
T/S
T/S

MSBOS Alphabetical By Surgical Category Revised 12/01/09 Page 3 of 15 Pages
GENERAL
PROCEDURE
MSBOS
Abdominal abscess drainage
Abdominal paracentesis
Abdominal perineal resection 2
Abdominal repair, rectal prolapse
Abscess drainage, abdominal, liver, lung
Adhesion, lysis for intestinal obstruction
Adrenalectomy 2
Anal fissure, excision of 0
Anal fistula, repair of 0
Anal polypectomy 0
Anterior colon resection
Anterior rectum resection 2
Antrectomy
Appendectomy
Axillary dissection, radical 0
Benign growth, simple / excessive 0
Biliary bypass 2
Biopsy, (lymph node, skin, muscle, breast, gland, bone marrow) 0
Bone marrow biopsy 0
Breast biopsy 0
Cecostomy
Cervical esophogostomy feeding tube
Change dressing 0
Cholecystectomy & common duct exploration
Cholecystoenterostomy
Cholecystogastrostomy
Cholecystojejunostomy
Cholecystostomy 0
Choledochojejunostomy 2
Cholesystectomy (open)
Colectomy, left 2
Colectomy, right
T/S
Colon resection, anterior
Colon resection, hemicolectomy
Colon resection, sigmoidectomy
Colon resection, small bowel segment
Colon resection, total large colon 2
Colonoscopy 0
Colostomy
Colostomy closure
Colostomy repair, revision of
Colovesical fistula
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S

MSBOS Alphabetical By Surgical Category Revised 12/01/09 Page 4 of 15 Pages
GENERAL
PROCEDURE
MSBOS
Common duct exploration
Debridement and closure, wound 0
Diaphragmatic hernia
T/S
Diverticulectomy, esophagus
Diverticulectomy, intestinal
Diverticulum, meckel's, excision of
Drainage abscess, abdominal, liver, lung
Drainage, empyema 2
Drainage, pseudocyst
T/S
Dressing change 0
Empyema, drainage of 2
Enteroenterostomy
Enterostomy
Esophogostomy feeding tube, cervical
T/S
Evacuation clots, abdomen 2
Evisceration repair, wound dehiscence
Excision of fecal fistula
Exploratory laparotomy
Exploratory laparotomy ( depends on reason) 2-5
Fecal fistula, excision
T/S
Fecal impaction 0
Fissure, anal, excision of 0
Fistula repair, anal 0
Foreign bodies, removal of (deep or superficial) 0
Gastrectomy 2
Gastrectomy with or without vagotomy, subtotal
Gastrectomy with or without vagotomy, total
Gastroenterostomy
Gastrojejunostomy
Gastroscopy 0
Gastrostomy 0
Gland biopsy 0
Graft, skin 0
Growth, benign and malignant simple, extensive 0
Hemicolectomy
Hemorrhoidectomy 0
Hepatectomy 4
Hernia, (hiatal, diaphragmatic, transthoracic) 2
Hernia, incisional
T/S
Hernia, inguinal 0
Hernia, mesh removal
Hernia, umbilical 0
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S

MSBOS Alphabetical By Surgical Category Revised 12/01/09 Page 5 of 15 Pages
GENERAL
PROCEDURE
MSBOS
Hernia, ventral 0
Ileal loop procedure, take - down / revision 2
Ileostomy
T/S
Ileostomy closure
Incision & drainage wound, abdominal
Incision and drainage of abscess, deep and superficial 0
Incisional hernia repair
Inguinal hernia 0
Intestinal diverticulectomy
T/S
Jejunostomy
Laparoscopic adrenalectomy 2
Laparoscopic appendectomy
Laparoscopic bowel surgery 2-5
Laparoscopic chole with cholangiogram
Laparoscopic cholecystectomy
Laparoscopic hepatic cyst excision
Laparoscopic inguinal herniorrhaphy
Laparoscopic insert peritoneal dialysis cath
Laparoscopic nissen (5) 2
Laparoscopic splenectomy 2
Laparoscopic ventral / incisional hernia
T/S
Laparotomy (varies with purpose)
Large colon, total resection 2
Left colectomy 2
Liver abscess drainage
Liver biopsy
T/S
Liver resection 4
Loop colostomy, small bowel
Low anterior resection 2
Lung abscess drainage
Lymph node biopsy 0
Lymph node dissection
Lymphadenectomy, pelvic
Lysis of adhesions
Malignant growth, simple / extensive 0
Mastectomy, radical or simple
Miles resection 2
Modified radical mastectomy
T/S
Muscle biopsy 0
Nissen fundoplication 2
Pancreatectomy (Whipple) 3
Pancreatic cyst drainage
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S

MSBOS Alphabetical By Surgical Category Revised 12/01/09 Page 6 of 15 Pages
GENERAL
PROCEDURE
MSBOS
Paracentesis, abdominal
Parathyroid exploration
Parathyroidectomy
Perineal resection, abdominal 2
Pilonidal cyst 0
Polypectomy, anal 0
Proctoscopy with or without fulguration or excision polyp 0
Radical axillary dissection 0
Radical mastectomy
T/S
Ramstedt op. (pyloroplasty)
Rectal polyp, excision 0
Rectal prolapse, abdominal repair
Rectocele repair
Rectum resection, anterior 2
Repair decubital ulcer
T/S
Repair rectal prolapse
Rib resection
Rib resection, cervical
Right colectomy
Sentinel node biopsy / axil node diss / lumpectomy
Sentinel node biopsy with nuclear med
Sigmoid colectomy
Sigmoidectomy
Sigmoidoscopy 0
Simple mastectomy
Skin biopsy 0
Skin flap 0
Skin graft 0
Small bowel resection
Small bowel segment
Splenectomy, abdominal or transthoracic 2
Subtotal thyroidectomy
Sympathectomy
Thyroidectomy
Toenail, removal of 0
Tracheostomy
Transverse colectomy
Umbilical hernia 0
Vagotomy 2
Whipple (radical pancreatectomy) 3
Wound dehiscence
Wound exploration
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S

MSBOS Alphabetical By Surgical Category Revised 12/01/09 Page 7 of 15 Pages
OB/GYN
PROCEDURE
MSBOS
A-P repairs combined incontinence 0
Bartholin's gland, excision of 0
Caesarean section (C-section) 0
Cauterization, cervix 0
Cervical polypectomy 0
Cervix, cauterization 0
Colporrhaphy, with or without perineorrhaphy 0
Condylomata, penile, vaginal, excision 0
Conization 0
Cystocele repair 0
D & C (dilation and curettage) 0
D & E (Dilation and evacuation), 2nd trimester only (>16 weeks) 0
Dilation and curettage (D & C) 0
Dilation and evacuation (D & E), 2nd trimester only (>16 weeks) 0
Ectopic pregancy 0
Fistula repair, rectovaginal 0
Fistula repair, vesicovaginal 0
Hymenectomy 0
Hysterectomy, abdominal 0
Hysterectomy, radical (Wertheim) 2
Hysterectomy, vaginal 0
Hysterotomy 0
Hysterotomy with repair 0
Laparoscopic salpingostomy 0
Laparoscopy and bilateral tubal ligation 0
Laparotomy, exploratory 0
Myomectomy 0
Myomectomy abdominal (open) 0
Ovarian wedge resection 0
Pelvic examination 0
Pelvic exenteration 3
Pelvic lymphadenectomy 0
Perineorrhaphy 0
Polypectomy, cervical 0
Salpingectomy 0
Salpingo - oophorectomy 0
Salpingoplasty 0
Tubal ligation, bilateral and laparoscopy 0
Uterine suspension with presacral neurectomy & fulgration of endometrial implants 0
Vaginal (rectovaginal) fistula repair 0
Vesicovaginal fistula repair 0

MSBOS Alphabetical By Surgical Category Revised 12/01/09 Page 8 of 15 Pages
OB/GYN
PROCEDURE
MSBOS
Vulvectomy, radical 4
Vulvectomy, simple 2
HAND
PROCEDURE
MSBOS
Amputation, finger 0
Amputation, hand 0
Arthrotomy 0
Dupuytren's contracture 0
Finger amputation 0
Fingernail, removal of 0
Hand amputation 0
Laceration, extensive and simple repair
T/S
Palmar fasciectomy 0
Release fibrous sheath, synovectomy finger 0
Ulnar transposition 0
NEUROSURGERY
PROCEDURE
MSBOS
Anterior / post spinal fusion 2
Anterior spine reconstruction / bone autograft 2
Anterior spine reconstruction with cage 2
Anterior spine reconstruction with pedicle screws 2
Cord tumors, removal of (varies with purpose)
T/S
Cordotomy
Cranioplasty
Craniotomy 2
Craniotomy, aneurysm 4 - 6
Craniotomy, sub-occipital 2
Decompression, suborbital or subtemporal
T/S
Disc fusion
Hematoma, subdural / epidural
Hemilaminectomy
Laminectomy (varies with purpose)
Laminectomy, lumbar for decompression
T/S
Nerve, graft 0
Nerve, repair 0
Nerve, section 0
Neurectomy, presacral
T/S
T/S
T/S
T/S
T/S
T/S
T/S

MSBOS Alphabetical By Surgical Category Revised 12/01/09 Page 9 of 15 Pages
NEUROSURGERY
PROCEDURE
MSBOS
Neurectomy, supraorbital
T/S
Post / lumbar instrum fusion
T/S
Posterior spine reconstruction, pedicle screws
T/S
Spinal fusion
T/S
Subdural hematoma
T/S
Suborbital decompression 2
Subtemporal decompression 2
ORTHO
PROCEDURE
MSBOS
Acromioplasty, shoulder 0
Ankle reconstruction
Anterior spine reconstruction / bone autograft 2
Anterior spine reconstruction with cage 2
Anterior spine reconstruction with pedicle screws 2
Arthroplasty
Arthroscopy 0
Arthrotomy 0
Bilateral total knee replacement 2
Bipolar hip 2
Bone flap reevaluation
Bone graft
Closed reduction, fracture with plaster cast 0
Disc fusion
Femoral rodding 2
Femur orif 2
Fibula orif 2
Fracture, hip 2
Girdlestone 2
Graft, bone
Hallux valgus repair 0
Hemilaminectomy
T/S
Hip fracture, hemiarthroplasty 2
Hip fracture, ODC 2
Hip fracture, richards repair 2
Hip nailing 2
Hip, pin removal
T/S
Hip, total replacement 3
T/S
T/S
T/S
T/S
T/S
T/S

MSBOS Alphabetical By Surgical Category Revised 12/01/09 Page 10 of 15 Pages
ORTHO
PROCEDURE
MSBOS
Hip, total revision 3
Humerus orif
T/S
Iliac crest bone graft
Irrigation & debridement / TKR
Knee, total 2
Laminectomy for decompression, thoracic
Laminectomy for tumor, thoracic 2
Meniscectomy 0
Osteotomy biopsy
Partial hip replacement 2
Partial knee replacement
Partial knee replacement revision 2
Plaster cast, body or extremity 0
Posterior spinal reconstruction with cage 2
Posterior spine reconstruction, bone autograft 2
Primary partial hip replacement 2
Primary total hip replacement 3
Retrograde femoral rodding
Shoulder fracture, hemiarthroplasty
Shoulder orif
Spine reconstruction / bone autograft, anterior 2
Spine reconstruction with cage, anterior 2
Spine reconstruction with pedicle screws, anterior 2
Supracondylar femur fracture 2
Thoracic laminectomy for decompression
T/S
Thoracic laminectomy for tumor 2
Tibia plateau fracture
Tibia, tumor excision of 0
Total hip replacement revision 3
Total knee replacement 2
Total knee replacement revision 2
Total shoulder replacement
T/S
Trochanteric nail 2
Ulnar transposition 0
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S

MSBOS Alphabetical By Surgical Category Revised 12/01/09 Page 11 of 15 Pages
OPHTHALMIC
PROCEDURE
MSBOS
Cataract 0
Chalazion, excision of 0
Ectropion 0
Enucleation 0
Filtering Procedure 0
Iridectomy 0
Iridenclysis 0
Orbital exploration
Strabismus 0
Vitrectomy 0
T/S
PLASTIC
PROCEDURE
MSBOS
Augmentation mammoplasty
T/S
Decubital ulcer
T/S
Foreign bodies, removal of (deep or superficial) 0
Mammoplasty augmentation
T/S
Mammoplasty reduction
T/S
Mammoplasty replacement
T/S
Nose, open and closed reduction 0
Nose, plastic repair 0
Otoplasty 0
Plastic repair, simple 0
Rhinoplasty 0

MSBOS Alphabetical By Surgical Category Revised 12/01/09 Page 12 of 15 Pages
THORACIC
PROCEDURE
MSBOS
Abscess drainage, lung
T/S
Bronchoscopy 0
Decortication, lung 2
Diaphragmatic hernia
Diverticulectomy, esophagus
Esophageal resection 4
Esophagectomy 4
Esophagectomy, trans hiatal 4
Esophagogastrectomy 3
Esophagus diverticulectomy
Hernia, diaphragmatic
Hernia, transthoracic
Lobectomy, lung 2
Lung abscess drainage
T/S
Lung decortication 2
Lung lobectomy 2
Pleurodesis / pleurectomy 2
Pneumonectomy 2
Pulmonary valvulotomy 4
Thoracotomy 2
Thoracotomy, exploratory
Trans hiatal esophagectomy 4
Transthoracic hernia
Valvulotomy, pulmonary 2
UROLOGY
T/S
T/S
T/S
T/S
T/S
T/S
T/S
PROCEDURE
MSBOS
Adrenalectomy 2
Bladder tumor, transurethral resection
Bladder, evacuation clots
Brachytherapy
Circumcision 0
CKU (Cold Knife Urethrotomy)
Condylomata, penile, vaginal, excision 0
Cystectomy with ileal loop procedure 2
Cystectomy, partial 2
Cysto & TURP
T/S
Cysto & turp with holmium yag laser
Cysto & turp, lithotripsy & bladder stone
T/S
T/S
T/S
T/S
T/S
T/S

MSBOS Alphabetical By Surgical Category Revised 12/01/09 Page 13 of 15 Pages
UROLOGY
PROCEDURE
MSBOS
Cysto acucise endopyelotomy
Cystoscopy 0
Cystoscopy & Retrograde 0
Cystoscopy Bladder Biopsy 0
Cystotomy
Dilation, urethra 0
Diverticulum, bladder (Excision of)
Epididymectomy 0
Evacuation clots, bladder
T/S
Hydrocelectomy 0
Ileal conduit
Ileal loop procedure, take - down / revision 2
Inguinal Node Dissection
Insertion urinary prosthesis
T/S
Laproscopic Nephrectomy, partial 2
Laproscopic Nephrectomy, radical 2
Marshall marchetti procedure
Meatotomy 0
Nephrectomy, partial 2
Nephrectomy, radical 2
Nephrectomy, transperitoneal
T/S
Nephrectomy, transthoracic 2
Nephrolithotomy / Pyelolithotomy 2
Nephrostomy
Nephroureterectomy 2
Open prostate biopsy
T/S
Orchidopexy 0
Orchiectomy (Simple) 0
Orchiectomy (Radical) 0
Pelvic node dissection, open
Penectomy (Partial)
Penectomy, (Total)
T/S
Percutaneous nephrolithotomy 2
Prostatectomy, radical perineal 2
Prostatectomy, radical retropubic 2
Prostatectomy, radical retropubic with nodes 2
Prostatectomy, suprapubic 2
Reimplantation of ureter
T/S
Renal artery repair 2
Renal exploration 2
Retroperitoneal lymph node dissection 2
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S

MSBOS Alphabetical By Surgical Category Revised 12/01/09 Page 14 of 15 Pages
UROLOGY
PROCEDURE
MSBOS
Spermatocelectomy 0
TVT (Transvaginal Tape) 0
Ureterectomy
T/S
Ureterolithotomy
Ureterostomy
Urethral diverticulum excision 0
Urethrectomy
Urethroplasty or sling operation
T/S
Vasectomy 0
Vaginal Vault Prolapse Repair 2
VASCULAR
T/S
T/S
T/S
PROCEDURE
MSBOS
AAA (Abdominal aortic aneurysmectomy) 3
Abdominal aortic aneurysmectomy (AAA) 3
Amputation, arm
Amputation, foot 0
Amputation, leg - above knee
Amputation, leg - below knee
T/S
Amputation, toe 0
Amputation, transmetatarsal 0
Aneurysm, abdominal resection 3
Aortic aneurysmectomy, abdominal (AAA) 3
Aortic aneurysmectomy, retroperitoneal 2
Aorto femoral bypass graft 2
Aorto iliac bypass graft 2
Aorto mesenteric bypass graft 2
Aorto renal bypass graft 2
Axillary femoral graft 2
Axillo bifemoral bypass graft 2
Axillo femoral bypass graft 2
Carotid body tumor resection
T/S
Carotid endarterectomy with EEG
Cervical rib resection
Cross pelvic bypass graft
Embolectomy
Endarterectomy
Endo vascular AAA (GORE)
Endo vascular AAA (MEDTRONIC) (S)
Excision, carotid body tumor 2
Femoral artery expolration / repair
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S

MSBOS Alphabetical By Surgical Category Revised 12/01/09 Page 15 of 15 Pages
VASCULAR
PROCEDURE
MSBOS
Femoral dorsalis pedis bypass graft
Femoral peroneal bypass graft
Femoral popliteal bypass graft
Femoral tibial bypass graft
Foot amputation 0
Ilio - femoral bypass graft
Leg amputation, above knee
Leg amputation, below knee
Ligation, carotid artery
Portocaval shunt 6
Repair aorta, dissecting rupture 5
Repair artery, lower extremity
Toe amputation 0
Transmetatarsal amputation 0
Varicose veins, ligation and stripping, bilateral 0
Varicose veins, ligation and stripping, unilateral 0
Vascular tumors 4
Vena cava inferior, ligation
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S
T/S