Management of third molar removal with a single dose of recombinant Factor IX (BeneFIX) and local measures in severe haemophilia B.

BACKGROUND

Patients with inherited bleeding disorders have historically had factor cover for oral surgery. Factor support is expensive, time consuming and places the patient at a potential risk of blood-borne diseases. This case describes the use of a significant reduction in factor support for a severe haemophilia B patient having third molars surgically removed.

METHODS

Local measures were used after a single preoperative dose of Factor IX to obtain good postoperative haemostasis.

RESULTS

Excellent haemostasis was achieved using local measures of 5% tranexamic acid solution, Surgicel® and Monocryl® sutures after a single preoperative dose of Factor IX.

CONCLUSIONS

Oral surgery may be performed on patients with inherited bleeding disorders using minimal factors and local haemostatic measures. A study of this patient population has commenced at The Alfred Hospital.