Gita Mehrotra
Maulana Azad Institute of dental sciences
India
Title: Management of patients with haemophilia in oral and maxillofacial surgery: a 5 years audit at a tertiary hospital
Biography
Biography: Gita Mehrotra
Abstract
Background: Maulana Azad Medical College is the largest tertiary centre in Delhi, India, having 3000 registered hemophiliac patients. The physiopathology of the hemorrhagic blood coagulation disorders is well known. Among these the most frequent ones include the type A-B Hemophilia and the von Willebrand disease. If they are not subjected to an adequate haemostatic prophylaxis, they present a serious hemorrhagic risk after dental procedure. Objectives: Oral surgical procedures in blood coagulation disorders are associated with high risk of bleeding. It requires a multidisciplinary approach and a well defined protocol. Objective of the present study is to review the efficacy of our protocol in order to reduce patient discomfort and to minimize the length of hospital stay. Methods: We conducted a retrospective study of patients from January 2009 to December 2014. We found records of 111 patients who underwent any type of oral surgical procedures. Efficacy of protocol was assessed by looking for the number of post-operative visits, need for extended /re hospitalisation, re transfusion of factors, episodes of post-operative bleeding and mortality of patient. Findings: Among 111 patients, 5 had mandibular fractures, 3 had benign pathology, and 28 had impacted third molars. We recorded 7 instances of postoperative bleeding. In 4 patients, bleeding stopped after compression whereas in 3 patients condition reverted to normalcy after infusion of the deficient clotting factor. Conclusions: Our protocol produced a favourable outcome. We were able to limit the duration of hospital stay to 1 hour in most of the cases, and were successful in improving patient’s comfort postoperatively.