Hemophilia Pre-Op Care: What You Need to Know Before Surgery

When you have hemophilia, a genetic bleeding disorder where the blood doesn’t clot properly. Also known as factor deficiency, it means even small cuts or surgeries can lead to serious internal bleeding. That’s why hemophilia pre-op care isn’t just a formality—it’s life-saving. Every surgery, whether it’s a tooth extraction or knee replacement, needs careful planning if you have hemophilia. Doctors don’t just hand you a consent form and send you in. They run tests, adjust your clotting factor levels, and coordinate with hematologists to make sure you’re protected.

Clotting factors are the core of this preparation. If you have hemophilia A, you’re missing factor VIII. If it’s hemophilia B, you’re low on factor IX. Before any operation, your medical team will give you an infusion of these factors to raise your levels to a safe range—usually 30% to 100% of normal, depending on the surgery. A minor procedure might need 30%, but major surgery like hip replacement? That could mean pushing to 80% or higher. Timing matters too. These infusions are given right before the cut, sometimes even during, and then repeated for days after to keep you stable as you heal. It’s not a one-time fix; it’s a multi-day plan.

It’s not just about the factors. Your team will check for inhibitors—antibodies your body might have made that block the treatment. If you have them, standard factor infusions won’t work, and they’ll switch to bypassing agents like recombinant factor VIIa. They’ll also review every medication you take. Even over-the-counter painkillers like ibuprofen can thin your blood and add risk. Aspirin? Out. Acetaminophen? Usually fine. Your surgeon and hematologist will talk to each other directly. No guesswork. No delays. And if you’re scheduled for dental work, they’ll coordinate with your dentist to use local anesthetics without epinephrine, which can cause bleeding.

There’s also the human side. You need to know what to watch for after surgery—unusual swelling, pain that gets worse instead of better, or bruising that spreads. These aren’t normal. They’re red flags. Your care team will give you a clear action plan: who to call, when to go to the ER, how to track your symptoms. And if you’re a parent preparing a child for surgery, they’ll walk you through how to explain it simply, how to keep them calm, and what to expect in recovery.

What you’ll find in the posts below aren’t just general tips. They’re real, practical guides from people who’ve been through this—how to talk to your surgeon, what questions to ask before signing consent forms, how to spot early signs of complications, and what to do if your insurance denies coverage for clotting factor. This isn’t theory. It’s what works.