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August 24, 1963

Elective Surgery in Hemophilia: II. Hematologic Control

Author Affiliations

Gainesville, Fla.

From the Division of Hematology, Department of Medicine, University of Florida College of Medicine.

JAMA. 1963;185(8):631-634. doi:10.1001/jama.1963.03060080027008

IDEALLY, the management of a patient with hemophilia who is to undergo operation should provide for completely normal hemostasis throughout the surgical procedure and postoperative convalescence. In practice, it is difficult to achieve this, both from a technical point of view and from the point of view of expense to the patient. Accordingly, we have studied the dose-response relationship of factor VIII in order to define a hemostatic level. These studies have the advantage that there has been only one traumatized site and that the location and extent of the injury are fairly well known.

Methods  Factor VIII levels were measured by the method of Pool and Robinson.1 This method was modified by obtaining several values during the generation of thromboplastic activity and using the average of the two shortest clotting times for purposes of converting to per cent of factor VIII activity. The factor VIII standard curve was obtained