Ambulatory oral surgery in hemophiliacs
Horowitz, I.; Graubart, U.; Gal, G.; Ramon, Y.; Seligsohn, U.
Harefuah 99(8): 201-203
1980
ISSN/ISBN: 0017-7768 PMID: 6971243 Document Number: 163931
Poor oral hygiene and extensive dental disease are very common among hemophiliacs, due to negligence and the reluctance of dentists to treat them. Consequently dental ailments often become a cause for hospitalization. Recent advances in the treatment of blood dyscrasias and of blood component deficiencies allow safe treatment of these patients on an ambulatory basis. During 1972-1978, 98 patients with hemophilia (A, B) and Von Willebrand's disease were examined: 28 required have 134 tooth extractions in 59 sessions. In only 2 cases were patients hospitalized because of postoperative complications. A course of the antifibrinolytic, Hexacapron, was started 1 day prior to extraction, and was continued for 7-10 days thereafter. On the day of extraction, i.v. infusion of the missing factor was given prior to the intervention to raise the level to 30% of normal. In the first 20 sessions an identical dose of the missing factor was given 12 h postoperatively. Following the subsequent 39 sessions, no postoperative infusions were given. Oral surgical procedures can be done in hemophiliacs on an ambulatory basis, with significant savings in blood products, medical manpower and money.