von Willebrand's disease and plastic surgery

Area of Science:

• Plastic Surgery
• Hematology
• Genetics

Background:

• Von Willebrand's disease (VWD) is the most common inherited bleeding disorder.
• VWD affects approximately 0.8-0.9% of the general population.
• Understanding VWD is crucial for managing patients undergoing plastic surgery.

Purpose of the Study:

• To investigate the prevalence of VWD in plastic surgery patients.
• To evaluate diagnostic methods for VWD in this population.
• To assess the perioperative management and outcomes of VWD patients.

Main Methods:

• Prospective study of 1,000 plastic surgery patients.
• Clinical evaluation including bleeding history and bruising.
• Coagulation studies: PT, PTT, platelet count, bleeding time, and factor VIII assay when indicated.

Main Results:

• VWD was detected in 9 patients (0.9%), predominantly female.
• All diagnosed patients reported a history of easy bleeding or bruising.
• Seven patients had VWD type I, one type II-a, and one type II-b.
• Perioperative bleeding was managed effectively with 1-deamino-8-D-arginine-vasopressin (DDAVP).

Conclusions:

• VWD is an important consideration in plastic surgery patients.
• A thorough bleeding history and appropriate coagulation testing are essential for diagnosis.
• DDAVP is an effective treatment for perioperative bleeding in VWD, with plasma products reserved for specific cases.