How is bleeding diathesis addressed during the dermatologic preoperative evaluation and management?

Updated: Mar 16, 2020
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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The presence of a bleeding diathesis is important to detect and reverse prior to surgery. Many underlying diseases, inherited disorders, and medications can interfere with the normal coagulation process. In general, bleeding disorders are due to abnormalities of the platelets, the intrinsic coagulation system, the extrinsic coagulation system, or a combination of these factors.

To properly screen for such abnormalities, one should inquire about a family history of bleeding problems; a personal history of problematic bleeding with prior trauma, surgeries, or dental procedures; a history of epistaxis or bleeding from the gums; a history of requiring blood transfusions; and a complete medication history. If a bleeding diathesis is suspected, the following tests should be obtained: a complete blood cell count, a platelet count, a prothrombin time (PT), and an activated partial thromboplastin time (aPTT). Further testing and management advice are best obtained by consulting with a hematologist.

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