title: No increased bleeding risk for oral surgery in patients with severe congenital bleeding disorders due to intense perioperative management.
abstract: OBJECTIVE
  In order to evaluate complication rates of dentoalveolar surgery in patients with congenital bleeding disorders, a retrospective case-control study was performed.
  
  
  METHODS
  A collective of patients with congenital bleeding disorders (n = 69), who received common oral surgery procedures in combination with intense perioperative monitoring and coagulation factor substitution at the University Hospital of Bonn between 1992 and 2011, was matched with patients without bleeding disorders by age, sex, and type of surgery. In addition to the rates of perioperative bleeding and other complications, the duration of surgery and the use of local hemostatic agents were compared between both cohorts.
  
  
  RESULTS
  There were no significant differences between the two groups regarding the rate of postoperative bleeding (2.9 vs. 1.4%, patients with congenital bleeding disorders vs controls) and the rate of other complications (7.2 vs. 21.7%). Furthermore, no significant difference in operation time (54 min in patients with congenital bleeding disorders vs 45 min in controls) was observed. However, there was a significant difference (p < 0.001) regarding the use of local hemostatic measures, which were applied in all patients with hereditary bleeding disorders but in only one of the controls. All patients with bleeding disorders were inpatients, while all controls were treated in an outpatient setting.
  
  
  CONCLUSIONS
  If adequate measures are taken, the complication rate following oral surgery in patients with hereditary bleeding disorders can be reduced to that of patients without bleeding disorders. However, these results are reached at significant costs due to coagulation factor replacement and inpatient treatment.
authors.affiliation: Institute of Experimental Hematology and Transfusion Medicine (IHT), University of Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Goldmann
authors.forename: C
authors.initials: C
authors.lastname: Berens
authors.forename: N
authors.initials: N
authors.lastname: Marquardt
authors.forename: R
authors.initials: R
authors.lastname: Reich
authors.forename: J
authors.initials: J
authors.lastname: Oldenburg
authors.forename: M
authors.initials: M
authors.lastname: Wenghoefer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D025861:Blood Coagulation Disorders, Inherited / Q000150:complications* / Q000188:drug therapy*; D001779:Blood Coagulation Factors / Q000008:administration & dosage*; D016063:Blood Loss, Surgical; D002648:Child; D002675:Child, Preschool; D005260:Female; D005858:Germany; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D019647:Oral Surgical Procedures; D019990:Perioperative Care / Q000379:methods*; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D001779:Blood Coagulation Factors