title: The burned hemophiliac.
abstract: Reports of the care of burned hemophiliac patients requiring cutaneous autografting are rare. A 28-year-old white male with classic hemophilia A sustained a 30.5% total body surface area burn. The patient received standard topical antimicrobial therapy and the majority of his burn wound healed. While undergoing therapy, multiple tooth extractions were recommended. On postburn day 25 the patient underwent multiple tooth extractions plus excision and grafting of his unhealed burn after preoperative infusion of cryoprecipitate. Despite a maximum factor VIII concentration of only 23%, no remarkable bleeding occurred from the excision sites, the skin graft donor site, or the tooth extraction wounds. Preoperative infusion of cryoprecipitate does not appear to be required for split-thickness skin graft harvest or excision of burns within the dermis.
authors.affiliation: United States Army Institute of Surgical Research, Fort Sam Houston, Texas 78234-6200.
authors.forename: A A
authors.initials: AA
authors.lastname: Smith
authors.forename: C W
authors.initials: CW
authors.lastname: Goodwin
authors.forename: W F
authors.initials: WF
authors.lastname: McManus
authors.forename: B A
authors.initials: BA
authors.lastname: Pruitt
mesh_terms: D000328:Adult; D002056:Burns / Q000150:complications* / Q000601:surgery; D005169:Factor VIII / Q000008:administration & dosage; D005340:Fibrinogen / Q000008:administration & dosage; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male
chemical_list: C026912:cryoprecipitate coagulum; D005169:Factor VIII; D005340:Fibrinogen