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Oxford University Hospitals NHS Foundation Trust
Clinical Haematology

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Surgery and bleeding disorders

Information for patients.

Major or minor surgery

For people with haemophilia A or haemophilia B, von Willebrand disease, other factor deficiencies, platelet disorders or an acquired bleeding disorder.

If you need surgery, contact the Haemophilia team and let them know the name of the hospital where you are having the procedure, as well as the name of the surgical consultant and the date and time of your surgery, as soon as possible.

The Haemophilia team can then contact your surgical team, to develop a care plan and organise any treatment you may require before and after the surgery (including blood tests). A specialist haemophilia nurse will call you to discuss your care plan, treatment and surgery.

You should also follow any advice given to you about your surgery during your pre-operative assessment appointment, as the Haemophilia team can only provide advice on treatment for your bleeding disorder.

For haemophilia carriers

Depending on your factor VIII (8) or factor IX (9) level, you may need treatment or monitoring before or after your surgery.

If you need surgery, contact the Haemophilia team and let them know the name of the hospital where you are having the procedure and the date and time of the surgery as soon as possible. They can then contact your surgical team, to develop a care plan and organise any treatment you may require before and after the surgery (including blood tests). A specialist haemophilia nurse will call you to discuss your care plan, treatment and surgery.

Length of stay

How long you stay in the hospital will depend on the surgery you are having and the length of the treatment for your bleeding disorder. If you are having minor surgery, you may be able to have the operation as a day case, which means you would normally go home the same day.

If you are having major surgery, you will most likely need to stay in hospital for 7-10 days, as you may require more intensive factor treatment after the operation, as well as monitoring of your factor levels to reduce your bleeding risk and minimise any surgery-related bleeding complications.

Your surgical team should be able to tell you how long you will need to stay in hospital following your operation. You can discuss this with your specialist surgical consultant.

Surgery in a different hospital

It is safest if your surgery takes place in a hospital with a Haemophilia Comprehensive Care Centre, such as the John Radcliffe Hospital, Churchill Hospital or Nuffield Orthopaedic Centre in Oxford. This is because the Haemophilia team is on site, so can provide care and treatment before and after the surgery.

If you have been listed for surgery in a hospital that is not in Oxford, let your Haemophilia team know. They can contact and speak to the surgical team in the other hospital, to organise your care. However, your haemophilia consultant or the Haemophilia team may ask for your surgery to be carried out in Oxford, so they can closely monitor you and provide treatment before and after your surgery. This close monitoring may not be available in hospitals outside of Oxford.

Private surgery

We do not generally recommend anyone registered with a bleeding disorder at the Oxford Haemophilia and Thrombosis Centre has private surgery, as we are unable to provide advice or treatment to a private consultant or hospital.

However, we would encourage you to contact the Haemophilia team and discuss this with your haemophilia consultant or specialist nurse, as they can give you advice about whether this is an appropriate route for your surgery or if you need to be referred to an NHS hospital (preferably in Oxford).

Endoscopy

If you are having an endoscopy procedure, such as a gastroscopy or colonoscopy, you should let your Haemophilia team know. They will need to know the type of endoscopy procedure you are having, as well as the date, time and where it is taking place.

They can then contact the Endoscopy Unit to arrange any treatment you may need before and after the procedure. Most procedures carried out by the Endoscopy Unit are usually day cases, so you wouldn't need to stay in hospital overnight.

Biopsies

If you are having a biopsy (a small sample of tissue collected), you should let your Haemophilia team know the type of biopsy you are having, as well as the date, time and where it is being done. They can then contact the relevant team to arrange any treatment you may need before and after the procedure.

For some biopsies you may need to stay in hospital overnight, to be monitored for any bleeding complications or further factor concentrate treatment.

Dental surgery

If you are having dental surgery, you should let your Haemophilia team know the type of dental surgery you are going to have (such as an extraction), as well as the date and time of the surgery.

We would usually recommend that your dental surgery is carried out at the East Oxford Dental Practice in Cowley, or at the John Radcliffe Hospital, so we can provide the necessary treatment before and afterwards, including blood tests and monitoring any bleeding complications. Most dental surgery is carried out as a day case, so you shouldn't need to stay in hospital overnight.

If your dental surgery is being carried out by your local dentist or hospital, you should discuss this with your haemophilia consultant or specialist nurse. They can provide advice about whether this is an appropriate route for your dental surgery or if you need to be referred to the East Oxford Dental Practice or John Radcliffe Hospital.

You may need factor concentrate or other treatment and blood tests before your dental surgery, which may not be available at your local dentists or hospital.

Other

If you are having another type of surgery or a procedure not already discussed, whether it is minor or major and being carried out in Oxford or at another hospital, please contact your haemophilia consultant or specialist nurse. They can talk with you about the type of treatment you may need before and after the surgery or procedure, to minimise your bleeding risk or any surgery-related bleeding complications, including the length of treatment and any recommended stay in hospital.

Emergency surgery

If you are admitted into hospital for emergency surgery, you (or the person accompanying you) should let the medical staff know that you have a bleeding disorder. The staff looking after you will need to contact the Haemophilia team at the Oxford Haemophilia and Thrombosis Centre. This is so that the correct advice and treatment can be given, to help minimise your bleeding risk or reduce any surgery-related bleeding complications. If you carry a bleeding disorder card, this can be shown to the medical staff, to direct them towards the Haemophilia team.

Surgery cancelled or postponed

If your surgery is cancelled or postponed, you should let your Haemophilia team know, so this can be noted on your medical records.

If you are given a new date and time, you should let your Haemophilia team know, so they can make sure the surgical teams are aware of the care and treatment plan in place to reduce your bleeding risk and minimise any surgery-related bleeding complications.

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