Management of surgical patients with bleeding disorders.

Invasive procedures for patients with bleeding disorders require planning on the part of the health care team. The patient population affected involves those with hereditary bleeding disorders, such as von Willebrand disease or hemophilia; in addition, patients who use antithrombotic drugs must be considered and their care managed. The choice of treatment depends on a number of factors, including the procedure planned, the type and severity of the disorder, and the age and morbidity of the patient. The indications, dosing, and timing of presurgical and surgical interventions will be reviewed, as well as special considerations for vascular access devices.