Rhinoplasty on patients with von Willebrand's disease: Tranexamic acid may be a better choice than desmopressin in selected cases


ÜSTÜN G. G., KAYA Z.

TURKISH JOURNAL OF PLASTIC SURGERY, cilt.30, sa.3, ss.82-84, 2022 (ESCI) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 30 Sayı: 3
  • Basım Tarihi: 2022
  • Doi Numarası: 10.4103/tjps.tjps_7_22
  • Dergi Adı: TURKISH JOURNAL OF PLASTIC SURGERY
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus
  • Sayfa Sayıları: ss.82-84
  • Anahtar Kelimeler: Bleeding, desmopressin, rhinoplasty, tranexamic acid, von Willebrand's disease
  • Gazi Üniversitesi Adresli: Evet

Özet

Von Willebrand's disease (VWD) is the most common hereditary bleeding disorder. Due to its frequency, occasionally, patients with this disease apply for rhinoplasty. Classically, desmopressin is used in emergent cases, and it is highly effective. However, the lack of long-term treatment and possible side effects limit the desmopressin treatment. Because the fibrinolytic activity in the nasal mucosa is high, antifibrinolytics such as tranexamic acid are beneficial in all types of VWD. An 18-year-old patient with Type 1 VWD who was operated without facing any complications is presented. Treatment involved 4 days of treatment starting the day before the surgery and healing process was uneventful. Patients with a diagnosis of VWD can be operated successfully with preoperative tranexamic acid treatment and using vasoconstrictor agents and avascular surgery planes. In Type 1 VWD or low von Willebrand's factor cases, tranexamic acid is a safe and successful treatment alternative due to its long-term use, local and systemic applicability, and regional affinity.