الفهرس 
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Abstract
Craniosynostosis is defined as the premature closure of one or more of the sutures normally separating the infant’s skull bony plates, causing abnormal growth of the cranial vault, which may affect brain growth and development. It can happen as an isolated defect (non-syndromic) or as part of a syndrome. Craniosynostosis results in deformity of both cranial and facial skeleton.
The main surgical therapy of metopic and coronal craniosynostosis is fronto orbital advancement and forehead reshaping which is associated with high rate of blood loss and transfusion.
Various strategies to minimize blood loss have been studied with variable results.
Our protocol was to increase preoperative Hgb by preoperative blood transfusion and minimize intraoperative blood loss by local tranexamic acid.
In this comparative study, there was no statistical significance regarding age, wight and sex. The same technique (FOA) was used for all cases.
Epo showed no significance on Hgb and Hct. So, Preoperative blood transfusion of 100 ml Packed RBCs was used which resulted in increase of Hgb by 2.7 gm/dl and Hct by 8.3%.
After application of our protocol, the CBL decreased from 64.3 to 28.1 % i.e: more than 50% improval. The intraoperative transfusion decreased from 185.8 ml (25.6% of total blood volume) to 75.8 ml (9.1% of total blood volume. The total transfusion decreased from 265.8 ml (36.5% of total blood volume) to 175.8 ml (20.9 % of total blood
Summary
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volume). The mean operative time decreased by about 39 minutes and total hospital stay by about 9 days.