Bloodless surgery was originally defined in the 1960s as the desired omission of the use of blood that is transfused. That simple definition, however, is not accepted as a complete description of bloodless surgery, which is why some individuals and organizations have expanded on the original one. A more thorough definition of bloodless surgery includes the requirement for the complete avoidance of transfused blood or blood products. Emphasis is placed as much on avoiding blood as it is on avoiding blood products. Highly advanced surgical procedures and techniques can be used to eliminate the need to use transfused blood or blood products. One of the principle differences between the two definitions is that the first includes the mere desire and attempt to exclude the use of transfused blood, and the second one absolutely requires such an exclusion. This is why not all bloodless surgery is truly bloodless. This statement refers to the possible failed attempt to avoid using transfused blood or blood products during surgery or other medical procedures. Medical procedures as well as actual surgery can be bloodless and thus referred to as bloodless surgery. There are good reasons why a person might want to avoid a blood transfusion or the administration of blood products. Diseases such as the various forms of hepatitis and the human immunodeficiency virus (HIV) might be contracted through the use of transfused blood or blood products. Although various safety measures have been put into place to help guard against such transmissions, there are no guarantees for patients against the reception of contaminated blood. People who hold religious views against the giving and receiving of blood are among those who are interested in bloodless surgery and medical procedures. Among the transfusion-free surgeries that can be performed are hip and knee replacements and open heart surgery. There also is sometimes the option to use what generally are considered to be safe substitutes for blood and blood products, such as saline solution and Ringer’s lactate. Some patients who want to ensure that they undergo bloodless surgery take out what is known as a “no blood medical directive.” They might also make their refusal to be administered blood or blood products known through another legal document called an advance medical directive. Such a document serves as instruction regarding medical care, and healthcare providers are required by law to respect and follow it. Source
