[Diagnosis and management of coagulation disorders in orthopedic surgery].
Patients suffering from von-Willebrand-disease or hemophilia A or B are the most common patients with coagulation disorders in orthopedic hospitals. Patients suffering from hemophilia A or B are treated with pure factor VIII or IX concentrates. We prefer recombinant products. The goals are normal levels of F VIII or F IX activity during the operation and postoperatively. In order to save costs the continuous infusion is recommended. Approximately 30% of products and costs may be saved. The prevalence of von-Willebrand-disease is very high in Europe and USA (1%). Typical presentation of these patients is the uncontrollable bleeding during an operation; typical is also the bleeding from mucous membranes. Patients with mild disorders are treated with DDAVP. Patients suffering from type 3 need substitution therapy with von-Willebrand-factor containing concentrates (for example Humate P).
Scharrer
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I
Zentrum der Inneren Medizin, Universitätskliniken Frankfurt/Main.
D001778:Blood Coagulation Disorders / Q000150:complications*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D006467:Hemophilia A / Q000150:complications*; D002836:Hemophilia B / Q000150:complications*; D006801:Humans; D009985:Orthopedics; D013514:Surgical Procedures, Operative / Q000009:adverse effects; D014842:von Willebrand Diseases / Q000150:complications*; D014841:von Willebrand Factor / Q000502:physiology*
D014841:von Willebrand Factor