How to prepare for surgery with hemophilia
Fact-checked by Preparing for surgery with a bleeding disorder like hemophilia often involves extra coordination, but many procedures can still be done safely with the right precautions.
Because hemophilia affects how your blood clots, your care team will likely take steps to lower bleeding risk and support recovery throughout the surgical process.
Why procedures need special planning in hemophilia
Hemophilia can cause bleeding to last longer after an injury, cut, or bruise because the blood does not clot normally due to a lack of certain blood-clotting proteins, or clotting factors. As a result, even minor surgical procedures can require extra safety measures, especially if they involve the mouth or other areas that bleed easily.Â
Planning for hemophilia surgery should start well before your procedure date. Your care team might need to check your clotting factor activity levels to better understand how well your blood may clot during and after the procedure. You may also be screened for inhibitors, which are antibodies that can prevent clotting factor replacement therapies that supply the missing clotting factors from working properly.
They’ll also review your bleeding and hemophilia treatment history, as well as other coexisting conditions that could increase your risk of bleeding, to develop an appropriate treatment plan that helps reduce bleeding risks around the time of your procedure.
Who should be on your care team before surgery?
Planning for surgery in patients with hemophilia works best when all healthcare professionals involved follow a single, coordinated care plan. Surgery should be coordinated with a team experienced in hemophilia care, along with lab support to monitor clotting factor activity levels. Your care team may include the following:
- Hematologist: A blood disease specialist who manages bleeding prevention and treatment
- Surgeon or dentist: The healthcare professional who performs the procedure
- Anesthesiologist: A doctor who manages anesthesia and pain control
- Nurses and hospital coordinators: Team members who assist with care, scheduling, and postoperative instructions
- Lab specialists: Professionals who perform blood tests
How treatment plans may change before, after surgery
Medical procedures with hemophilia often require temporary treatment adjustments. For some surgeries, your team may need to give clotting factor replacement shortly before the procedure to raise your clotting factor activity levels when the bleeding risk is highest.
Dosing is typically based on your weight, baseline clotting factor level, and the type of surgery being performed. Clotting factor replacement treatment will typically continue for several days after the procedure to reduce the risk of bleeding complications, with major surgeries requiring a longer treatment duration.Â
In some situations, other medications may be used to keep bleeding under control. These include antifibrinolytics, which prevent blood clots from being broken down and are commonly used for oral or dental procedures.
Questions to ask before surgery
Understanding your treatment plan ahead of time can help you feel more prepared and confident about the safety of hemophilia procedures. Along with any other personal concerns you already have, consider asking your care team:
- Who should I call if I experience bleeding or other complications?
- What blood tests will I need before or after my procedure?
- How will my treatment schedule change around surgery?
- Are there any medicines or supplements I should avoid?
- What bleeding symptoms require immediate attention?
Don’t hesitate to ask questions. Your care team is there to provide guidance and support throughout the entire process.
Recovering from surgery
Recovery can depend on the type of procedure, your hemophilia severity, and how well bleeding is controlled afterward. Before leaving the hospital or clinic, make sure you know when to take any follow-up treatments, whether additional blood tests are needed, and when to return for follow-up care.Â
People who receive clotting factor treatment around the time of surgery may need inhibitor testing four to 12 weeks later.
After orthopedic surgery, physical therapy can help improve movement and recovery, but sessions often need to be coordinated with bleeding prevention treatment.
When to contact your doctor after a procedure
Even with the right precautions in place, bleeding can still occur after surgery or dental work with hemophilia.
Contact your doctor or hemophilia treatment center if bleeding lasts longer than expected, starts again after stopping, or develops several days after your procedure.
Unexpected bleeding or other symptoms may require additional blood tests or factor monitoring to identify the cause. With prompt medical support, many complications can be addressed early before they become more serious.
Hemophilia News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
