Perioperative Management of von Willebrand Disease in Dermatologic Surgery

• Published in: Dermatologic surgery 2007-04, Vol.33 (4), p.403-409
• Main Authors: LEONARD, AIMEE L, HANKE, C WILLIAM, GREIST, ANNE
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Blood Loss, Surgical - prevention & control; Dermatologic Surgical Procedures; Dermatology; Hematologic and hematopoietic diseases; Hemostasis, Surgical; Humans; Medical sciences; Perioperative Care; Platelet diseases and coagulopathies; Postoperative Hemorrhage - prevention & control; Postoperative Hemorrhage - therapy; Skin plastic surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; von Willebrand Diseases - diagnosis; von Willebrand Diseases - therapy
• ISSN: 1076-0512; 1524-4725
• DOI: 10.1097/00042728-200704000-00002

BACKGROUNDVon Willebrand disease (VWD) is the most common inherited bleeding disorder, affecting an estimated 0.1% to 1% of the population. It is caused by a qualitative or quantitative defect of von Willebrand factor. Primary manifestations include intractable mucocutaneous bleeding after surgery or trauma. OBJECTIVEThe objective was to review the pathophysiology and clinical features of VWD and to propose a perioperative management strategy for patients with this condition undergoing dermatologic surgery. METHODS AND MATERIALSLiterature is reviewed. RESULTSThe various types and clinical manifestations of this condition are reviewed, and a perioperative strategy is presented for managing patients with VWD who undergo cutaneous oncologic or cosmetic surgical procedures. CONCLUSIONSIn most cases, dermatologic surgery can be safely performed in patients with VWD. The use of appropriate therapeutic prophylaxis in conjunction with a hematologist is indicated in high-risk, nonelective procedures.