[Surgery in haemophilic patients (author's transl)]

Abstract

This paper deals with a total of 108 major surgical procedures in haemophilic patients of type A or type B, performed during the last 20 years. The principles of adequate substitution therapy are described, as well as the indications for surgery and the surgical technique. The importance of prolonged postoperative substitution therapy to avoid late haemorrhage and haematoma formation, is stressed. By combining substitution therapy with immuno-suppresive measures, it is also possible to operate on patients with inhibitors against factor VIII or IX. It is concluded that major surgery can be carried out even in severe haemophilia without significantly increased risk.