Pub Date : 2021-03-23DOI: 10.5772/INTECHOPEN.96969
M. Patriarco, S. Shenoy, N. Taylor
In Obstetrics and Gynecology, the practice of biologic hemostatic agents in the field are generally used to augment the basic tenets of hemostasis to decrease the morbidity and mortality of such procedures. These hemostatic agents work along with the body’s physiology to rapidly aid in platelet plug formation, activation of the clotting cascade, the creation of fibrin, and to form a stable clot. The four main sub-categories of hemostatic agents include mechanical, biological, flowable, and fibrin sealants. Mechanical agents act as scaffolding for platelet aggregation to form a platelet plug. Biological agents activate clotting factors in the coagulation cascade to aid in hemostasis. Flowable agents combine biologic with mechanical agents to stabilize clot formation while also providing mechanical tamponade. Fibrin sealants combine high levels of fibrin and thrombin that when combined, form a fibrin clot at an accelerated speed. Hemostatic agents in obstetrics are often used in the setting of postpartum hemorrhage, cesarean delivery and postpartum hysterectomy to decrease the rate of morbidity most commonly seen with abnormal placentation and uterine atony. With gynecologic surgery, hemostatic agents are more commonly used then in obstetrics. They aid in hemostasis with common gynecologic procedures including hysterectomies, ovarian cystectomies, myomectomies, endometriosis cases, incontinence procedures and malignant debulking procedures. Also, with the increase in minimally invasive surgical techniques, topical hemostasis can aid in fewer transfusions, improved visualization in the surgical field decreased operative time and reduction in the risk of conversion to laparotomy.
{"title":"Biologic Hemostatic Agents in Obstetrics and Gynecology","authors":"M. Patriarco, S. Shenoy, N. Taylor","doi":"10.5772/INTECHOPEN.96969","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.96969","url":null,"abstract":"In Obstetrics and Gynecology, the practice of biologic hemostatic agents in the field are generally used to augment the basic tenets of hemostasis to decrease the morbidity and mortality of such procedures. These hemostatic agents work along with the body’s physiology to rapidly aid in platelet plug formation, activation of the clotting cascade, the creation of fibrin, and to form a stable clot. The four main sub-categories of hemostatic agents include mechanical, biological, flowable, and fibrin sealants. Mechanical agents act as scaffolding for platelet aggregation to form a platelet plug. Biological agents activate clotting factors in the coagulation cascade to aid in hemostasis. Flowable agents combine biologic with mechanical agents to stabilize clot formation while also providing mechanical tamponade. Fibrin sealants combine high levels of fibrin and thrombin that when combined, form a fibrin clot at an accelerated speed. Hemostatic agents in obstetrics are often used in the setting of postpartum hemorrhage, cesarean delivery and postpartum hysterectomy to decrease the rate of morbidity most commonly seen with abnormal placentation and uterine atony. With gynecologic surgery, hemostatic agents are more commonly used then in obstetrics. They aid in hemostasis with common gynecologic procedures including hysterectomies, ovarian cystectomies, myomectomies, endometriosis cases, incontinence procedures and malignant debulking procedures. Also, with the increase in minimally invasive surgical techniques, topical hemostasis can aid in fewer transfusions, improved visualization in the surgical field decreased operative time and reduction in the risk of conversion to laparotomy.","PeriodicalId":127797,"journal":{"name":"Contemporary Applications of Biologic Hemostatic Agents across Surgical Specialties - Volume 2 [Working Title]","volume":"105 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115639166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-05DOI: 10.5772/INTECHOPEN.96081
Laraib Safeer, S. Agarwala, A. Krakowski, Ryan P. Johnson
Performed in an outpatient, office-based setting, dermatologic surgery reduces healthcare costs of hospitalization while maintaining low rates of surgical complications such as infection, dehiscence, and hematoma formation. However, the potential for complications requiring hospitalization or IV antibiotic therapy still exists and varies depending on patient risk factors, such as the use of antiplatelet and anticoagulant medications. Furthermore, measured outcomes in dermatologic surgery expand beyond surgical wound complications to include optimization of wound healing and reduction of scar formation, especially in cosmetically sensitive areas of the body. Biosurgical agents are increasingly being used in surgical fields to achieve hemostasis and to optimize wound healing. This chapter reviews the typical methods to achieve hemostasis in dermatologic surgery and examines the current and future role of biosurgical agents in procedural dermatology.
{"title":"The Role of Biosurgical Agents in Dermatologic Surgery","authors":"Laraib Safeer, S. Agarwala, A. Krakowski, Ryan P. Johnson","doi":"10.5772/INTECHOPEN.96081","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.96081","url":null,"abstract":"Performed in an outpatient, office-based setting, dermatologic surgery reduces healthcare costs of hospitalization while maintaining low rates of surgical complications such as infection, dehiscence, and hematoma formation. However, the potential for complications requiring hospitalization or IV antibiotic therapy still exists and varies depending on patient risk factors, such as the use of antiplatelet and anticoagulant medications. Furthermore, measured outcomes in dermatologic surgery expand beyond surgical wound complications to include optimization of wound healing and reduction of scar formation, especially in cosmetically sensitive areas of the body. Biosurgical agents are increasingly being used in surgical fields to achieve hemostasis and to optimize wound healing. This chapter reviews the typical methods to achieve hemostasis in dermatologic surgery and examines the current and future role of biosurgical agents in procedural dermatology.","PeriodicalId":127797,"journal":{"name":"Contemporary Applications of Biologic Hemostatic Agents across Surgical Specialties - Volume 2 [Working Title]","volume":"250 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122138244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-11DOI: 10.5772/INTECHOPEN.95244
Z. Frenzel, D. Manchester
Patients undergoing cardiothoracic surgery, especially open cardiac procedures requiring cardiopulmonary bypass, are exposed to several alterations in primary and secondary hemostasis. These derangements are associated with increased microvascular bleeding that is refractory to conventional surgical maneuvers aimed at achieving hemostasis. This poses a technical problem for the surgeon and exposes the patient to increased morbidity from uncontrolled bleeding and any associated transfusion of blood products. Use of biosurgical hemostatic agents, specifically in patients undergoing cardiac surgery, have been shown to be safe and effective in reducing time to hemostasis, decreasing transfusion of blood products, and improving patient outcomes. Despite their merits, selection of a topical hemostat is frequently based on anecdotal experience and limited knowledge of the available agents. The prepared surgeon is familiar with these agents and can anticipate opportunities for their deployment in the setting of coagulopathy.
{"title":"Biosurgical Hemostasis in Thoracic and Cardiac Surgery: A Practical Approach","authors":"Z. Frenzel, D. Manchester","doi":"10.5772/INTECHOPEN.95244","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.95244","url":null,"abstract":"Patients undergoing cardiothoracic surgery, especially open cardiac procedures requiring cardiopulmonary bypass, are exposed to several alterations in primary and secondary hemostasis. These derangements are associated with increased microvascular bleeding that is refractory to conventional surgical maneuvers aimed at achieving hemostasis. This poses a technical problem for the surgeon and exposes the patient to increased morbidity from uncontrolled bleeding and any associated transfusion of blood products. Use of biosurgical hemostatic agents, specifically in patients undergoing cardiac surgery, have been shown to be safe and effective in reducing time to hemostasis, decreasing transfusion of blood products, and improving patient outcomes. Despite their merits, selection of a topical hemostat is frequently based on anecdotal experience and limited knowledge of the available agents. The prepared surgeon is familiar with these agents and can anticipate opportunities for their deployment in the setting of coagulopathy.","PeriodicalId":127797,"journal":{"name":"Contemporary Applications of Biologic Hemostatic Agents across Surgical Specialties - Volume 2 [Working Title]","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134066062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-11DOI: 10.5772/intechopen.94528
Rodrigo Duarte-Chavez, S. Mehta, J. Bahirwani, R. Modi, S. Stawicki
Gastrointestinal endoscopy has evolved to become a therapeutic resource for multiple pathologic conditions, utilizing many techniques, tools and materials from the field of conventional surgery. Thermal, mechanical or chemical modalities are often employed to expedite the process of hemostasis and achieve a stable coagulum. Thermocoagulation coupled with devices for mechanical hemostasis have been adapted successfully to endoscopy. Chemical hemostasis from biomaterials can be obtained from biologically active materials such as thrombin and fibrin, absorbable products such as gelatins, collagen and oxidized cellulose or synthetic products and inorganic powders. Aside from hemostatic properties, biomaterials are also appealing due to its ability to promote wound healing. However, the use of biomaterials has not been as widespread in endoscopy as in conventional surgery, mainly because of the constraint of delivering these materials through an endoscope. Over the last decade, the options for biomaterials have expanded and its incorporation in endoscopy has slowly increased. Although the cost of biomaterials is higher compared to traditional hemostatics, this may be offset by the potential benefits of decreased bleeding related complications, procedure time, hospital stay and blood transfusions. Biomaterials have demonstrated an improvement in clinical outcomes during conventional surgery. Nevertheless, more studies are required to extrapolate these benefits to endoscopy.
{"title":"The Use of Biomaterials in Gastrointestinal Endoscopy","authors":"Rodrigo Duarte-Chavez, S. Mehta, J. Bahirwani, R. Modi, S. Stawicki","doi":"10.5772/intechopen.94528","DOIUrl":"https://doi.org/10.5772/intechopen.94528","url":null,"abstract":"Gastrointestinal endoscopy has evolved to become a therapeutic resource for multiple pathologic conditions, utilizing many techniques, tools and materials from the field of conventional surgery. Thermal, mechanical or chemical modalities are often employed to expedite the process of hemostasis and achieve a stable coagulum. Thermocoagulation coupled with devices for mechanical hemostasis have been adapted successfully to endoscopy. Chemical hemostasis from biomaterials can be obtained from biologically active materials such as thrombin and fibrin, absorbable products such as gelatins, collagen and oxidized cellulose or synthetic products and inorganic powders. Aside from hemostatic properties, biomaterials are also appealing due to its ability to promote wound healing. However, the use of biomaterials has not been as widespread in endoscopy as in conventional surgery, mainly because of the constraint of delivering these materials through an endoscope. Over the last decade, the options for biomaterials have expanded and its incorporation in endoscopy has slowly increased. Although the cost of biomaterials is higher compared to traditional hemostatics, this may be offset by the potential benefits of decreased bleeding related complications, procedure time, hospital stay and blood transfusions. Biomaterials have demonstrated an improvement in clinical outcomes during conventional surgery. Nevertheless, more studies are required to extrapolate these benefits to endoscopy.","PeriodicalId":127797,"journal":{"name":"Contemporary Applications of Biologic Hemostatic Agents across Surgical Specialties - Volume 2 [Working Title]","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123008247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-13DOI: 10.5772/intechopen.93196
Andrew Konopitski, C. Nwachuku
Significant blood loss is an obstacle frequently encountered in orthopedic surgery in both elective and trauma settings. Notwithstanding the nature of orthopedic surgery creates a unique environment, where hemostasis may be difficult to achieve. In total hip and knee arthroplasty, freshly cut bone edges bleed persistently and often do not respond to typical hemostatic methods utilized in soft tissues. Spine surgery requires strict adherence to hemostatic principles as uncontrolled bleeding can result in compression of neural elements. Blood loss in orthopedic trauma presents a highly variable environment where methods of hemostasis must match the severity of the injury. Lastly, orthopedic tumor procedures often require bloodless fields in order to limit the risk of hemostatic spread. The following chapter takes a subspecialized approach to blood loss management in orthopedic surgery, including perioperative management of anticoagulant medications, protocols for utilization of pharmacologic agents, and techniques for the application of topical hemostatic compounds.
{"title":"Hemostatic Adjuncts in Orthopedic Surgery: Innovations in Technique, Technology, and Biosurgical Applications","authors":"Andrew Konopitski, C. Nwachuku","doi":"10.5772/intechopen.93196","DOIUrl":"https://doi.org/10.5772/intechopen.93196","url":null,"abstract":"Significant blood loss is an obstacle frequently encountered in orthopedic surgery in both elective and trauma settings. Notwithstanding the nature of orthopedic surgery creates a unique environment, where hemostasis may be difficult to achieve. In total hip and knee arthroplasty, freshly cut bone edges bleed persistently and often do not respond to typical hemostatic methods utilized in soft tissues. Spine surgery requires strict adherence to hemostatic principles as uncontrolled bleeding can result in compression of neural elements. Blood loss in orthopedic trauma presents a highly variable environment where methods of hemostasis must match the severity of the injury. Lastly, orthopedic tumor procedures often require bloodless fields in order to limit the risk of hemostatic spread. The following chapter takes a subspecialized approach to blood loss management in orthopedic surgery, including perioperative management of anticoagulant medications, protocols for utilization of pharmacologic agents, and techniques for the application of topical hemostatic compounds.","PeriodicalId":127797,"journal":{"name":"Contemporary Applications of Biologic Hemostatic Agents across Surgical Specialties - Volume 2 [Working Title]","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114799649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-21DOI: 10.5772/intechopen.89991
J. Clanton, K. Seal
Through innovative technologies and refinement of surgical technique over the last several decades, hepatopancreatobiliary (HPB) surgeries have become increasingly common for both malignant and benign disease. HBP surgeries often present unique challenges even for the experienced surgeon, whether due to liver cirrhosis causing portal hypertension and impairment of natural clotting abilities or a large pancreatic mass invading into nearby mesenteric vessels. Major intraoperative blood loss is still a concern and is known to be a major factor influencing morbidity and mortality. Biosurgicals are increasingly used as adjuncts to reduce blood loss during these complex procedures, but also to even reduce rates of biliary and pancreatic leaks and fistulas postoperatively. While initially biosurgical agents offered some hope to make the difference in completing a safe and effective operation, more recent and rigorous studies have failed to demonstrate reproducible benefits. This chapter reviews the use of hemostatic agents in the setting of hepatobiliary and pancreatic surgery, including for the maintenance of hemostasis and the prevention of biliary and pancreatic leaks. We also discuss what factors should be considered when choosing the correct agents for different clinical scenarios during HPB surgery.
{"title":"Use of Biosurgicals in Hepatobiliary Surgery","authors":"J. Clanton, K. Seal","doi":"10.5772/intechopen.89991","DOIUrl":"https://doi.org/10.5772/intechopen.89991","url":null,"abstract":"Through innovative technologies and refinement of surgical technique over the last several decades, hepatopancreatobiliary (HPB) surgeries have become increasingly common for both malignant and benign disease. HBP surgeries often present unique challenges even for the experienced surgeon, whether due to liver cirrhosis causing portal hypertension and impairment of natural clotting abilities or a large pancreatic mass invading into nearby mesenteric vessels. Major intraoperative blood loss is still a concern and is known to be a major factor influencing morbidity and mortality. Biosurgicals are increasingly used as adjuncts to reduce blood loss during these complex procedures, but also to even reduce rates of biliary and pancreatic leaks and fistulas postoperatively. While initially biosurgical agents offered some hope to make the difference in completing a safe and effective operation, more recent and rigorous studies have failed to demonstrate reproducible benefits. This chapter reviews the use of hemostatic agents in the setting of hepatobiliary and pancreatic surgery, including for the maintenance of hemostasis and the prevention of biliary and pancreatic leaks. We also discuss what factors should be considered when choosing the correct agents for different clinical scenarios during HPB surgery.","PeriodicalId":127797,"journal":{"name":"Contemporary Applications of Biologic Hemostatic Agents across Surgical Specialties - Volume 2 [Working Title]","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133335901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-06DOI: 10.5772/intechopen.89992
N. Campos, F. Furlaneto, Y. Buischi
Excessive bleeding complicates surgery and may result in a higher risk of morbidity in dentistry. Although multiple evidence-based clinical guidelines regard dental interventions as minor procedures, with low risk of bleeding, patients on anticoagulation therapy are at elevated risk of bleeding complications, during and following dental surgeries. In many instances, discontinuation or altering of anticoagulation can be avoided through the use of local hemostatic agents during or after the procedure (or both), while patients are therapeutically continued on their prescribed anticoagulant doses. In addition, patients with diagnosis of hereditary bleeding disorders, such as von Willebrand disease and hemophilia, and individuals without any history of bleeding complications can present the need for the use of topical hemostatic agents. In this chapter, we discuss the mechanisms of action, practical applications, effectiveness, and potential negative effects of biosurgical topical hemostatic agents, such as gelatin sponges, collagen, oxidized regenerated cellulose (ORC) and oxidized cellulose, fibrin sealants, flowables, adhesives, and topical thrombin in dental surgery.
{"title":"Bleeding in Dental Surgery","authors":"N. Campos, F. Furlaneto, Y. Buischi","doi":"10.5772/intechopen.89992","DOIUrl":"https://doi.org/10.5772/intechopen.89992","url":null,"abstract":"Excessive bleeding complicates surgery and may result in a higher risk of morbidity in dentistry. Although multiple evidence-based clinical guidelines regard dental interventions as minor procedures, with low risk of bleeding, patients on anticoagulation therapy are at elevated risk of bleeding complications, during and following dental surgeries. In many instances, discontinuation or altering of anticoagulation can be avoided through the use of local hemostatic agents during or after the procedure (or both), while patients are therapeutically continued on their prescribed anticoagulant doses. In addition, patients with diagnosis of hereditary bleeding disorders, such as von Willebrand disease and hemophilia, and individuals without any history of bleeding complications can present the need for the use of topical hemostatic agents. In this chapter, we discuss the mechanisms of action, practical applications, effectiveness, and potential negative effects of biosurgical topical hemostatic agents, such as gelatin sponges, collagen, oxidized regenerated cellulose (ORC) and oxidized cellulose, fibrin sealants, flowables, adhesives, and topical thrombin in dental surgery.","PeriodicalId":127797,"journal":{"name":"Contemporary Applications of Biologic Hemostatic Agents across Surgical Specialties - Volume 2 [Working Title]","volume":"242 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124934209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-30DOI: 10.5772/intechopen.90016
O. Badulescu, Iris Bararu Bojan, M. Vlădeanu, C. Bădescu, Andrei Bojan, P. Sîrbu, M. Ciocoiu
Hemophilia is a genetic or acquired disease that leads to spontaneous and recurrent bleedings, which affect the joints and muscles, thus determining chronic damage to the cartilage which will lead to joint disease and hemophilic arthropathy. Even though hemophilic patients were initially thought to have a low incidence of atherothrombotic complications, it is now clear that atherothrombotic events occur. The administration of plasmatic factor VIII has better clinical results in type A hemophilic patients than the transfusion with plasma. We analyzed five patients with hemophilia type A, aged between 35 and 62 years. Two of them had a severe form of hemophilia with factor VIII less than 1%, while the other three had a moderate form with factor VIII ranging between 1 and 5%. The five patients underwent total knee repair interventions and received substitution treatment with clotting factors but also prophylactic anticoagulant treatment. The postsurgical evolution of these patients was favorable, with similar hemostatic profile as the non-hemophilic patients. Moroctocog alfa is an efficient substitutive treatment that manages to normalize the hemostatic profile of patients. Therefore, it is recommended to provide prophylactic antithrombotic therapy after the orthopedic interventions.
{"title":"Optimal Management of Elective Joint Replacement Surgery in Patients with Hemophilia","authors":"O. Badulescu, Iris Bararu Bojan, M. Vlădeanu, C. Bădescu, Andrei Bojan, P. Sîrbu, M. Ciocoiu","doi":"10.5772/intechopen.90016","DOIUrl":"https://doi.org/10.5772/intechopen.90016","url":null,"abstract":"Hemophilia is a genetic or acquired disease that leads to spontaneous and recurrent bleedings, which affect the joints and muscles, thus determining chronic damage to the cartilage which will lead to joint disease and hemophilic arthropathy. Even though hemophilic patients were initially thought to have a low incidence of atherothrombotic complications, it is now clear that atherothrombotic events occur. The administration of plasmatic factor VIII has better clinical results in type A hemophilic patients than the transfusion with plasma. We analyzed five patients with hemophilia type A, aged between 35 and 62 years. Two of them had a severe form of hemophilia with factor VIII less than 1%, while the other three had a moderate form with factor VIII ranging between 1 and 5%. The five patients underwent total knee repair interventions and received substitution treatment with clotting factors but also prophylactic anticoagulant treatment. The postsurgical evolution of these patients was favorable, with similar hemostatic profile as the non-hemophilic patients. Moroctocog alfa is an efficient substitutive treatment that manages to normalize the hemostatic profile of patients. Therefore, it is recommended to provide prophylactic antithrombotic therapy after the orthopedic interventions.","PeriodicalId":127797,"journal":{"name":"Contemporary Applications of Biologic Hemostatic Agents across Surgical Specialties - Volume 2 [Working Title]","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134325952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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