Management of third molar removal with a single dose of recombinant Factor IX (BeneFIX) and local measures in severe haemophilia B.

Background: Patients with inherited bleeding disorders have historically had factor cover for oral surgery. Factor support is expensive, time consuming and places the patient at a potential risk of blood-borne diseases. This case describes the use of a significant reduction in factor support for a severe haemophilia B patient having third molars surgically removed. Methods: Local measures were used after a single preoperative dose of Factor IX to obtain good postoperative haemostasis. Results: Excellent haemostasis was achieved using local measures of 5% tranexamic acid solution, Surgicel (R) and Monocryl (R) sutures after a single preoperative dose of Factor IX. Conclusions: Oral surgery may be performed on patients with inherited bleeding disorders using minimal factors and local haemostatic measures. A study of this patient population has commenced at The Alfred Hospital.