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Nail Surgery for patient with Von Willebrand's Disease?

Discussion in 'General Issues and Discussion Forum' started by viennapod, Nov 12, 2011.

  1. viennapod

    viennapod Member

    Members do not see these Ads. Sign Up.
    I have a 54 year old female, referred by her GP for surgical management of ingrowing toenails. Initially she was referred to the local hospital for surgery due to her bleeding disorder, Von Willebrand's disease. However, hospital cut backs have hit and she has been removed from their waiting list.
    i have not treated anyone with this disorder before and just looking for some advice regarding pre and post op care. I'm looking at doing a bilateral matrixectomy with NaOH/Acetic acid.
  2. Admin2

    Admin2 Administrator Staff Member

    Von Willebrand disease

    Von Willebrand disease (vWD) (/ˌfʌnˈvɪlɪbrɑːnt/), discovered by Erik Adolf von Willebrand, is the most common hereditary blood-clotting disorder in humans. An acquired form can sometimes result from other medical conditions.[1] It arises from a deficiency in the quality or quantity of von Willebrand factor (vWF), a multimeric protein that is required for platelet adhesion. It is known to affect humans and several breeds of dogs. The three forms of vWD are: hereditary, acquired, and pseudo or platelet type. The three types of hereditary vWD are: vWD type 1, vWD type 2, and vWD type 3. Type 2 contains various subtypes.[2] Platelet type vWD is also an inherited condition.[3]

    vWD type 1 is the most common type of the disorder which is typically asymptomatic, though mild symptoms such as nosebleeds may occur, and occasionally more severe symptoms. Blood type can affect the presentation and severity of symptoms of vWD.[4]

    vWD type 2 is the second most common type of the disorder and has mild to moderate symptoms.

    vWD is named after Erik Adolf von Willebrand, a Finnish physician who first described the disease in 1926.[5]

    1. ^ "Von Willebrand disease: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2016-06-26. 
    2. ^ Goodeve, A (1993). "von Willebrand Disease". PMID 20301765. 
    3. ^ Swystun, Laura L.; James, Paula D. (2016). "Genetic Diagnosis in Hemophilia and von Willebrand disease". Blood Reviews. doi:10.1016/j.blre.2016.08.003. ISSN 0268-960X. 
    4. ^ https://www.hemophilia.org/Bleeding-Disorders/Types-of-Bleeding-Disorders/Von-Willebrand-Disease
    5. ^ doctor/2690 at Who Named It?
  3. Jose Antonio Teatino

    Jose Antonio Teatino Well-Known Member

    If the technique for incisional onychocryptosis is really not, you should have problemas.
    Personalmente Fenol use.
    Is common practice in patients treated with acenocoumarol.
    Jose A. Teatino
    Professor of Surgery
    The Academy of Ambulatory Foot & Ankle Surgery
  4. Jose Antonio Teatino

    Jose Antonio Teatino Well-Known Member

    I meant: there should be problemas.
    Lamento google my bad English
  5. barry hawes

    barry hawes Active Member

    Hi all,

    About 20 years ago I did a partial nail ablation on an 18 yo young lady. Procedure went fine but I couldn't stop the bleeding, even after 10 minutes of digital pressure. Finally stopped with alginate packing, further pressure, elevation and time. Wound healed uneventfully and there was no nail regrowth.

    The young lady came to see me with another foot condition 5 years later. By then she had delivered her first child and, in the process, had been diagnosed with Von Willebrand's disease.

    For what it's worth, now that you are forwarned, perhaps dressing materials which enhance clotting may enable you to safely provide PNA on your patient. As an aside, I have used alginate dressings when performing PNAs on patients low doses of warfarin as well.

    Would be interested to hear of your reasons for chosing NaOH over phenol, and details of how you apply and neutralise it.

    Kind regards,

    Barry Hawes

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