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Identifying and managing inhibitor patients requiring orthopaedic surgery – the multidisciplinary team approach
Author(s) -
LUDLAM C.
Publication year - 2005
Publication title -
haemophilia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.213
H-Index - 92
eISSN - 1365-2516
pISSN - 1351-8216
DOI - 10.1111/j.1365-2516.2005.01152.x
Subject(s) - medicine , haemophilia , multidisciplinary team , prothrombin complex , factor viia , surgery , intervention (counseling) , multidisciplinary approach , intensive care medicine , hemostatic agent , general surgery , hemostasis , coagulation , tissue factor , nursing , social science , sociology
Summary. Until recently, surgery in haemophilia patients with inhibitors was strongly contraindicated and was therefore often not even contemplated. Inhibitor patients entering the surgical arena face unique challenges; the most frequently encountered problem during surgical intervention is bleeding, and thrombosis is occasionally observed. The activated prothrombin complex concentrate, FEIBA TM , and recombinant activated factor VII (rFVIIa) are available as haemostatic cover during surgery. The use of rFVIIa enables inhibitor patients to undergo orthopaedic surgery with an expectation of success, and results are generally good. An organized team approach is critical to this success. However, further information is required to enable different procedures to be optimized in terms of both outcome and safety.