Preoperative prednisone therapy in platelet function disorders

Excessive bleeding during surgical procedures may occur in patients with disorders of platelet function. This report describes a prospective study of preoperative prednisone therapy in preventing excessive post-surgical bleeding in 14 patients with various forms of qualitative platelet defects (“aspirin-like” defect). All patients had a history of excessive bleeding, a prolonged bleeding time, and diminished platelet aggregation with epinephrine and/or collagen. A trial of prednisone therapy was instituted prior to elective surgery. In all cases, the bleeding time was corrected to the normal range of less than 10 minutes. Platelet aggregation abnormalities were, however, unchanged. Surgery performed included dental extractions, and major abdominal, orthopedic, cardiac and ophthalmologic procedures. In no instance was excessive bleeding noted during or following surgery. Platelet transfusions were not needed in these patients. It is concluded that short term prednisone therapy, monitored by the bleeding time, is effective in preventing excessive surgical bleeding in certain patients with platelet function disorders.