What is severe liver disease 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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Severe liver disease is associated with decreased protein synthesis, which can manifest in disorders of coagulation and impaired wound healing. End-stage liver disease caused by hepatitis B or hepatitis C may create bleeding dyscrasias. The patient may require preoperative fresh-frozen plasma or clotting factors. Additionally, antibiotics and anesthetics that are metabolized in the liver should be avoided. Drugs to avoid or to use with extreme caution include sedatives, lidocaine, and amide-linked local anesthetics.

Surprisingly, patients with HIV disease are not predisposed to postoperative infections and decreased wound healing.

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