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Minimizing factor requirements for surgery without increased risk
Author(s) -
Schulman S.,
Loogna J.,
Wallensten R.
Publication year - 2004
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.1745-6584.2005.0048.x
Subject(s) - medicine , haemophilia , blood loss , incidence (geometry) , surgery , knee replacement , orthopedic surgery , total hip replacement , antifibrinolytic , quality of life (healthcare) , tranexamic acid , physics , nursing , optics
Summary. The most common type of surgical procedure in patients with haemophilia is orthopaedic surgery on the lower limb. These procedures are of great importance for the improvement of the function and quality of life of patients with haemophilia, but in many countries resources are lacking to provide the factor concentrates needed for these operations. We have attempted to reduce the level of replacement during and after total hip or total knee replacement without jeopardizing the outcome of the procedures. The results from 30 operations in 27 patients are presented. Steady‐state levels down to 0.5 IU mL −1 did not appear to increase the amount of blood loss or cause an increased incidence of complications, compared with higher levels. In addition, we review the possibilities to reduce the amount of factor concentrate by performing a combination of orthopaedic procedures and using local haemostatic agents or antifibrinolytic agents.