What is a common complication in patients with severe von Willebrand's disease after surgery?

Von Willebrand's disease is a genetic disorder that affects blood clotting, primarily due to a deficiency or dysfunction of von Willebrand factor, which is crucial for platelet adhesion and aggregation. In patients with severe von Willebrand's disease, the ability to form stable clots is significantly impaired.

After surgery, these patients are particularly vulnerable to prolonged bleeding due to their underlying coagulopathy. This complication arises because surgical procedures typically involve blood vessel incisions and tissue manipulation, which can trigger bleeding. In normal circumstances, the body responds effectively to such injuries through the clotting process. However, individuals with severe von Willebrand's disease lack the necessary factors to form clots efficiently, resulting in bleeding that lasts longer than expected.

While infection risk, slower recovery, and anemia are potential concerns in any surgical patient, they are not direct consequences of the pathology present in von Willebrand's disease as clearly as prolonged bleeding is. In fact, the risk of increased bleeding directly correlates with the nature of the surgery and the severity of the patient's clotting disorder, making it a most immediate and critical complication to consider in the perioperative care of these patients.