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March 1976

Thermal Injury in von Willebrand Disease: Management of Burn Wound Bleeding

Author Affiliations

From the US Army Institute of Surgical Research, Brooke Army Medical Center, Fort Sam Houston, Tex (Drs Andes and Bowman and Mr Baron), Walter Reed Army Institute of Research, Walter Reed Army Medical Center, Washington, DC, and the University of Connecticut Health Center, Farmington (Dr Rickles). Dr Andes is now with Tulane University Medical School, New Orleans.

Arch Surg. 1976;111(3):280-283. doi:10.1001/archsurg.1976.01360210074014

• A 51-year-old woman sustained a 40% third-degree burn. After five grafting procedures that were unsuccessful due to uncontrolled bleeding, the diagnosis of von Willebrand disease was established. Skin grafting was subsequently accomplished without difficulty using cryoprecipitate as a source of antihemophilic factor (factor VIII). Serial clinical and laboratory investigations demonstrated that using the level of factor VIII procoagulant activity alone as an in vitro index of hemostasis was insufficient as a guide to the control of pathologic burn wound bleeding in this patient.

(Arch Surg 111:280-283, 1976)

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