Surgical Risk on Patients with Coagulopathies: Guidelines on Hemophiliac Patients for Oro-Maxillofacial Surgery

Abstract

Background: Haemophilia is a disease of genetic origin, which causes a defect in blood coagulation. Under normal conditions, in the case of leakage from the blood vessels, the blood forms a clot that reduces or blocks the bleeding. This process involves the activation of several plasma proteins in a cascade-like species. Two of these proteins, produced in the liver, factor VIII and factor IX, are deficient or present a functional defect in people with haemophilia. Because of this deficit, the haemophiliacs easily suffer external and internal bleeding. Surgical treatment of these patients is to be observed, and often their treatment is delayed due to unclear guidelines and risks in treating these patients. The aim is to provide clear guidelines in the case of surgical treatment of these patients. Methods: In this study, we have considered all the guidelines that refer to the gold-maxillofacial surgery, focusing on the literature of the last 10 years. Results: Surely, this collection of guidelines will favor the choice of the clinician towards safer and predictable protocols. This study does not want to create a guideline but evaluates the literature of the last 10 years, and highlights the latest for the treatment of these patients., with the aim of informing the pathology and at the same time making the surgical maneuvers safer. Conclusions: Despite the research of literature has produced few results, it was nevertheless possible to draw up a guideline thanks to additional information extrapolated from textbooks and other scientific articles. According to the guidelines, it is possible to proceed to the treatment of these patients, if with appropriate therapy in a safe and risk-free manner.

Oral Health and Molecular Aspects of Malignant Fibrous Histiocytoma Patients: A Systematic Review of the Literature

“…Only one study reported a relapse of the disease 2 weeks after a first surgery consisting of local excision with maxillectomy [38], while 4 studies made no reference to recurrence [32][33][34]40]. These invasive surgeries often require post-surgical rehabilitations [51,52], and in some cases are made complex by the presence of local contraindications (noble anatomical structures [53][54][55][56], or systemic contraindications (general health conditions of the patient [22][23][24]26,57]). Post-surgical and infection management are important [27,28,30].…”

“…Distant metastases of MFH commonly occur via hematogenous or lymphatic spread [1,6,20,21]. Unfortunately, it is not always possible to intervene in a timely manner in these cases, due to delays related to diagnosis or systemic conditions of the patient who need adequate protocols or therapies [22][23][24]. Many syndromic patients or those suffering from systemic diseases may also present intra and post-operative complications [23,25,26] or represent a high post-surgical infection risk [27][28][29] and therefore need adequate therapies [27,30].…”

Oral Health and Fibromyalgia Syndrome: A Systemic Review

“…Medications used for fibromyalgia that may be beneficial for masticatory muscle pain according to De Rossi et al [22]. There are several syndromes and diseases which, due to their characteristics, can be similar to fibromyalgia as symptoms, and which will be excluded, even though they may be concomitant; among them, there are mainly: Sjögren syndrome, due to the low nuclear antibodies contained, multiple sclerosis, other systemic neurological syndromes, arthritis and arthrosis [37,39,[58][59][60][61][62][63]. Due to the impossibility of formulating a diagnosis based on medical evidence, and especially considering the equivocal nature of fibromyalgia, there is no universally adopted therapy whose efficacy is scientifically proven, different drugs are used [59], such as non-steroidal anti-inflammatory drugs (NSAIDs), selective serotonin reuptake inhibitors (SSRIs), cannabinoids, and muscle relaxants.…”

Mobile Dental Delivery System: An Effective Protocol for Hygiene and Disinfection

“…Because concerned people are mostly vulnerable and weakened, and because there are comorbidities associated with these procedures [9,22], it is important that dental treatment under GA is performed as safely as possible [14]. For example, some cancer patients or hemophiliac patients could require hospitalization and could undergo dental procedures under GA. Based on the high risk of bleeding in patients with coagulopathies, guidelines have been established, particularly including the use of antibacterial mouthwash in the preoperative part, but no mouth rinsing for 24 h in the postoperative period [23]. As such, ensuring the diminution of the bacterial load in these vulnerable patients' mouths is important.…”