The Burned Hemophiliac
作者:
MARTIN DURTSCHI,
RICHARD COUNTS,
DAVID HEIMBACH,
期刊:
The Journal of Trauma: Injury, Infection, and Critical Care
(OVID Available online 1980)
卷期:
Volume 20,
issue 8
页码: 706-708
ISSN:0022-5282
年代: 1980
出版商: OVID
数据来源: OVID
摘要:
Major surgical procedures are now performed with acceptable risk on patients with hemophilia A with pre- and postoperative anti-hemophilic Factor (AHF) infusions. However, there is almost no literature on care of the burned hemophiliac. We recently treated a patient with Factor VIII levels of less than 2% of normal and 45% TBSA burns. A forearm escharotomy was done with hemostatic protection by AHF infusion, but burn therapy, which included operative debridement and successful split-thickness skin grafting, was accomplished without use of AHF. It is concluded that after early loading with cryoprecipitate, burned hemophiliacs do not require continued AHF, because repair and restoration of vascular integrity in small vessels may occur due to platelet plugging and vessel retraction. Tissue thromboplastin may also contribute to clotting in burned hemophiliacs.
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