title: Management of third molar removal with a single dose of recombinant Factor IX (BeneFIX) and local measures in severe haemophilia B.
abstract: 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.
authors.affiliation: The Alfred Hospital, Prahran, Victoria. i.hewson@alfred.org.au
authors.forename: I D
authors.initials: ID
authors.lastname: Hewson
authors.forename: P
authors.initials: P
authors.lastname: Makhmaloaf
mesh_terms: 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
chemical_list: D000933:Antifibrinolytic Agents; D002483:Cellulose, Oxidized; D003029:Coagulants; D006490:Hemostatics; D011994:Recombinant Proteins; D014148:Tranexamic Acid; C013695:Surgicel; D005164:Factor IX