Management of patients with inherited bleeding disorders in oral surgery: A 13-year experience - 13/02/22

Doi : 10.1016/j.jormas.2022.02.003

Cécile Landart ^a, Virginie Barbay ^b, Pierre Chamouni ^b, Olivier Trost ^a,^c,^d,^⁎
^a Department of Oral and Maxillofacial Surgery, Rouen University Hospital, Rouen Normandy University, 1 rue de Germont, Rouen F-76000, France
^b Haemophilia Treatment Centre, Laboratory of Hematology, Rouen University Hospital, Rouen Normandy University, 1 rue de Germont, Rouen F-76000, France
^c Inserm, Rouen Normandy University, Sorbonne University, University of Paris 13, Laboratory of Medical Informatics and Knowledge Engineering in e-Health, LIMICS, Paris F-75006, France
^d Laboratory of Anatomy, Rouen Faculty of Medicine, Rouen Normandy University, 22 boulevard Léon-Gambetta, Rouen F-75006, France

^⁎Corresponding author at: Department of Oral and Maxillofacial Surgery, Rouen University Hospital, Rouen Normandy University, 1 rue de Germont, Rouen F-76000, France.Department of Oral and Maxillofacial SurgeryRouen University HospitalRouen Normandy University1 rue de GermontRouenF-75006France

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Sunday 13 February 2022
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Abstract

Introduction

The management of patients with inherited bleeding disorders in oral surgery requires the systematic evaluation of bleeding risk and the setting up of an adequate treatment protocol by the referring haematologist, defining a replacement therapy and a recommended length of hospital stay. The purpose of this study was to determine the bleeding risk associated with oral surgery for each type of inherited bleeding disorder and to evaluate the efficacy of the treatment protocols set up in our tertiary care center.

Materials and methods

We included all patients with an inherited bleeding disorder, managed in our oral and maxillofacial surgery department with a treatment protocol set up by our local Haemophilia Treatment Centre for an oral surgical procedure.

Results

Between January 2006 and December 2018, 295 treatment protocols were set up for the management of patients with haemorrhagic risk in oral surgical procedures. Of these, 203 were scheduled to take place in our department. A total of 180 oral surgical procedures for 147 patients were included. The incidence of bleeding complications in our study was 4.44% (8 out of 180) with a significantly higher risk in patients with haemophilia, the mean time to onset of bleeding was 11 days.

Discussion

The use of a treatment protocol for the management of patients with inherited bleeding disorders in oral surgery seems effective. Our rate of bleeding complications was comparable to data in the literature, and often lower.

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Keywords : Blood coagulation disorders, Inherited, Oral surgical procedures, Haemorrhage, Complications