Dental surgery with minimal factor support in the inherited bleeding disorder population at the Alfred Hospital.
In oral surgery, patients with inherited bleeding disorders have historically had factor cover where possible. Factor support is expensive, time consuming to administer and places the patient at a potential risk of complications of therapy. A protocol employing rigorous local measures and minimal factor replacement was used to obtain haemostasis following simple and complex oral surgery on 50 consecutive patients with inherited bleeding disorders, referred to the Alfred Health Dental Unit from the Ronald Sawers Haemophilia Centre, Alfred Health, Melbourne. Excellent haemostasis was achieved using standardized local measures of 5% tranexamic acid solution, surgicel and monocryl sutures. Oral surgery may be considered safe to perform in patients with inherited bleeding disorders using minimal factor support and meticulous local haemostatic measures.
Hewson
I
I
Dental Services Alfred Health Melbourne, Victoria, Australia. I.Hewson@alfred.org.au
Makhmalbaf
P
P
Street
A
A
McCarthy
P
P
Walsh
M
M
D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D025861:Blood Coagulation Disorders, Inherited / Q000150:complications*; D001779:Blood Coagulation Factors / Q000008:administration & dosage; D002483:Cellulose, Oxidized / Q000627:therapeutic use; D004146:Dioxanes / Q000627:therapeutic use; D006470:Hemorrhage / Q000517:prevention & control*; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D009067:Mouthwashes / Q000627:therapeutic use; D019647:Oral Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D011091:Polyesters / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control; D013537:Sutures; D014148:Tranexamic Acid / Q000627:therapeutic use
D000933:Antifibrinolytic Agents; D001779:Blood Coagulation Factors; D002483:Cellulose, Oxidized; D004146:Dioxanes; D009067:Mouthwashes; D011091:Polyesters; C095495:glycolide E-caprolactone copolymer; D014148:Tranexamic Acid; C013695:Surgicel