Newer Hemostatic Agents Used in the Practice of Dermatologic Surgery

Table 4

Acquired and inherited coagulopathies and management.

	Mechanism	Monitoring	Treatment
Acquired coagulopathies
Uremia (chronic renal failure)	Qualitative defect in platelets with a normal platelet count.	BT or PFA-100	DDAVP; per patients nephrologist, hemodialysis, or peritoneal dialysis [31, 32].
Liver cirrhosis	Decreased production of the clotting factors; coincident splenomegaly can lead to sequestration of platelets and thrombocytopenia.	PT, aPTT, BT, and platelet count	Vitamin K, FFP, recombinant Factor VIIa, Cryoprecipitate, Platelet transfusions, Prothrombin complex concentrates, and Desmopressin [33].
Inherited coagulopathies
Von-Willebrand’s disease	Decreased production of von-Willebrand’s factor and factor VIII.	BT, aPTT	DDAVP, factor VIII concentrates, Cryoprecipitate [34].
Hemophilia A	Decreased Factor VIII.	aPTT	Factor VIII concentrates, DDAVP [34].
Hemophilia B	Decreased factor IX.	aPTT	Factor IX concentrates [34].

Abbreviations: aPTT: activated partial thromboplastin time, BT: bleeding time, DDAVP: desmopressin, FFP: fresh frozen plasma, PFA-100: platelet function analyzer, and PT: prothrombin time.