[The hemophiliac as a surgical patient (author's transl)]

In the Surgical Clinic of the University of Munich, 23 surgical interventions were performed on 20 hemophiliac patients between 1967 and 1976. There were 13 emergency and 10 elective operations. The spectrum ranged from removal of atheroma to subtotal gastric resection. For adequate substitution of factors a comprehensive preoperative "hemostasis profile", selection of a suitable preparation and postoperative supervision with coagulation analysis are necessary. Despite a normalization of the hemostasis, atraumatic surgical technique is particularly important. Risks of substitution therapy are primarily hepatitis, allergic reactions and the appearance of inhibitors. Whereas, especially using low-fibrogenic substrates, the operative risk is not essentially increased, in our experience the patients seem to be endangered particularly by infection and septic complications.