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No increased bleeding risk for oral surgery in patients with severe congenital bleeding disorders due to intense perioperative management

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Abstract

Purpose

In order to evaluate complication rates of dentoalveolar surgery in patients with congenital bleeding disorders, a retrospective case–control study was performed.

Methods

A collective of patients with congenital bleeding disorders (n = 69), who received common oral surgery procedures in combination with intense perioperative monitoring and coagulation factor substitution at the University Hospital of Bonn between 1992 and 2011, was matched with patients without bleeding disorders by age, sex, and type of surgery. In addition to the rates of perioperative bleeding and other complications, the duration of surgery and the use of local hemostatic agents were compared between both cohorts.

Results

There were no significant differences between the two groups regarding the rate of postoperative bleeding (2.9 vs 1.4 %, patients with congenital bleeding disorders vs controls) and the rate of other complications (7.2 vs 21.7 %). Furthermore, no significant difference in operation time (54 min in patients with congenital bleeding disorders vs 45 min in controls) was observed. However, there was a significant difference (p < 0.001) regarding the use of local hemostatic measures, which were applied in all patients with hereditary bleeding disorders but in only one of the controls. All patients with bleeding disorders were inpatients, while all controls were treated in an outpatient setting.

Conclusions

If adequate measures are taken, the complication rate following oral surgery in patients with hereditary bleeding disorders can be reduced to that of patients without bleeding disorders. However, these results are reached at significant costs due to coagulation factor replacement and inpatient treatment.

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Funding

The authors state that they did not receive funding for this work from any of the following organizations: National Institutes of Health (NIH); Wellcome Trust; Howard Hughes Medical Institute (HHMI); and other(s).

Conflict of interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Institute of Experimental Hematology and Transfusion Medicine (IHT), University of Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany

    G. Goldmann, C. Berens, N. Marquardt & J. Oldenburg

  2. Department of Oral and Maxillofacial Plastic Surgery, University of Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany

    R. Reich & M. Wenghoefer

Authors
  1. G. Goldmann
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  2. C. Berens
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  3. N. Marquardt
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  4. R. Reich
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  5. J. Oldenburg
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  6. M. Wenghoefer
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Corresponding author

Correspondence to M. Wenghoefer.

Additional information

G. Goldmann and C. Berens contributed equally to this paper.

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Goldmann, G., Berens, C., Marquardt, N. et al. No increased bleeding risk for oral surgery in patients with severe congenital bleeding disorders due to intense perioperative management. Oral Maxillofac Surg 19, 195–200 (2015). https://doi.org/10.1007/s10006-014-0476-z

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  • DOI: https://doi.org/10.1007/s10006-014-0476-z

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