Defects of the clotting mechanism in blood dyscrasias and their significance in oral surgery

Abstract

The defects that hinder effective blood coagulation are nearly always due to either lack of a plasma coagulation factor or a serious diminution or absence of platelets. Information concerning this is usually volunteered by the patient or readily obtained from a history, and often it is obtained from inspection of the patient. Confirmation and more detailed data can be learned from routine and easily performed laboratory tests. Any surgical treatment afforded these patients should be as conservative as possible and should be performed only to give relief obtainable in no other way. They should be premedicated in order to correct the specific abnormality as much as possible, and procedures should be performed with the greatest possible care. Adequate precautions to prevent postoperative infection are essential. Frequently, a period of postoperative bleeding is to be expected, and sufficient preparations to control this and to compensate for it should be made in advance. Finally, each case of a patient suffering from one of the foregoing diseases will present its own special problems in addition to those discussed here or in the literature. Their proper resolution is dependent upon the good clinical judgment and knowledge of the practitioner.