Over two decades of orthopaedic surgery in patients with inhibitors—Quantifying the complication of bleeding

Patients with haemophilia who have developed inhibitors against factor VIII (FVIII) or factor IX present a significant concern to those surgeons who operate on them. The evidence base for bypassing agents such as recombinant factor VIIa and activated prothrombin complex concentrate has amassed over...

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Bibliografski detalji
Glavni autori: Erturan, G, Guevel, B, Alvand, A, Goddard, NJ
Format: Journal article
Jezik:English
Izdano: Wiley 2018
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author Erturan, G
Guevel, B
Alvand, A
Goddard, NJ
author_facet Erturan, G
Guevel, B
Alvand, A
Goddard, NJ
author_sort Erturan, G
collection OXFORD
description Patients with haemophilia who have developed inhibitors against factor VIII (FVIII) or factor IX present a significant concern to those surgeons who operate on them. The evidence base for bypassing agents such as recombinant factor VIIa and activated prothrombin complex concentrate has amassed over several decades. The literature is open to positive interpretation on the successful use of these agents in the treatment of inhibitor‐positive patients. However, there are equally persistent concerns amongst surgeons, in particular orthopaedic surgeons, regarding the high complication rate of bleeding. To explore and quantify this concern, we present a literature review spanning two decades of publications on haemophilia patients with inhibitors undergoing orthopaedic surgery. Irrespective of the progress made with haemostatic protocols, trepidation on embarking on surgery is valid. The high risk of bleeding is a function of the inherent complexity of the disease and rightfully translates into difficulties in its management. Combined with the prospect of orthopaedic surgery, those involved in the care of such patients are justified in their continued anxiety and diligence when considering the benefits in quality of life against the prevalent complications.
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spelling oxford-uuid:f05cf52d-2f8d-4bad-9915-37065f4a8fd52022-03-27T11:47:16ZOver two decades of orthopaedic surgery in patients with inhibitors—Quantifying the complication of bleedingJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f05cf52d-2f8d-4bad-9915-37065f4a8fd5EnglishSymplectic Elements at OxfordWiley2018Erturan, GGuevel, BAlvand, AGoddard, NJPatients with haemophilia who have developed inhibitors against factor VIII (FVIII) or factor IX present a significant concern to those surgeons who operate on them. The evidence base for bypassing agents such as recombinant factor VIIa and activated prothrombin complex concentrate has amassed over several decades. The literature is open to positive interpretation on the successful use of these agents in the treatment of inhibitor‐positive patients. However, there are equally persistent concerns amongst surgeons, in particular orthopaedic surgeons, regarding the high complication rate of bleeding. To explore and quantify this concern, we present a literature review spanning two decades of publications on haemophilia patients with inhibitors undergoing orthopaedic surgery. Irrespective of the progress made with haemostatic protocols, trepidation on embarking on surgery is valid. The high risk of bleeding is a function of the inherent complexity of the disease and rightfully translates into difficulties in its management. Combined with the prospect of orthopaedic surgery, those involved in the care of such patients are justified in their continued anxiety and diligence when considering the benefits in quality of life against the prevalent complications.
spellingShingle Erturan, G
Guevel, B
Alvand, A
Goddard, NJ
Over two decades of orthopaedic surgery in patients with inhibitors—Quantifying the complication of bleeding
title Over two decades of orthopaedic surgery in patients with inhibitors—Quantifying the complication of bleeding
title_full Over two decades of orthopaedic surgery in patients with inhibitors—Quantifying the complication of bleeding
title_fullStr Over two decades of orthopaedic surgery in patients with inhibitors—Quantifying the complication of bleeding
title_full_unstemmed Over two decades of orthopaedic surgery in patients with inhibitors—Quantifying the complication of bleeding
title_short Over two decades of orthopaedic surgery in patients with inhibitors—Quantifying the complication of bleeding
title_sort over two decades of orthopaedic surgery in patients with inhibitors quantifying the complication of bleeding
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