Management of third molar removal with a single dose of recombinant Factor IX (BeneFIX) and local measures in severe haemophilia B.
BACKGROUND
Patients with inherited bleeding disorders have historically had factor cover for oral surgery. Factor support is expensive, time consuming and places the patient at a potential risk of blood-borne diseases. This case describes the use of a significant reduction in factor support for a severe haemophilia B patient having third molars surgically removed.


METHODS
Local measures were used after a single preoperative dose of Factor IX to obtain good postoperative haemostasis.


RESULTS
Excellent haemostasis was achieved using local measures of 5% tranexamic acid solution, Surgicel® and Monocryl® sutures after a single preoperative dose of Factor IX.


CONCLUSIONS
Oral surgery may be performed on patients with inherited bleeding disorders using minimal factors and local haemostatic measures. A study of this patient population has commenced at The Alfred Hospital.
Hewson
I D
ID
The Alfred Hospital, Prahran, Victoria. i.hewson@alfred.org.au
Makhmaloaf
P
P
D000328:Adult; D000933:Antifibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002483:Cellulose, Oxidized / Q000008:administration & dosage / Q000627:therapeutic use; D003029:Coagulants / Q000627:therapeutic use*; D005164:Factor IX / Q000627:therapeutic use*; D005500:Follow-Up Studies; D002836:Hemophilia B / Q000188:drug therapy*; D006488:Hemostasis, Surgical / Q000379:methods; D006490:Hemostatics / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D011292:Premedication; D011994:Recombinant Proteins; D014081:Tooth Extraction / Q000379:methods*; D020390:Tooth Socket / Q000187:drug effects / Q000601:surgery; D014095:Tooth, Impacted / Q000601:surgery*; D014148:Tranexamic Acid / Q000008:administration & dosage / Q000627:therapeutic use
D000933:Antifibrinolytic Agents; D002483:Cellulose, Oxidized; D003029:Coagulants; D006490:Hemostatics; D011994:Recombinant Proteins; D014148:Tranexamic Acid; C013695:Surgicel; D005164:Factor IX