Abstract

PURPOSE
The aim of this prospective observational study was to evaluate the incidence of postoperative bleeding after dental extraction in candidates for liver transplantation and the efficacy of the association of tranexamic acid and absorbable hemostatic sponges.
PATIENTS AND METHODS
All individuals referred for oral health evaluation requiring extraction were considered in this study. Patients were included in the analysis when the blood examinations showed a platelet count of 30,000/mm(3) or greater and an international normalized ratio (INR) of 3.0 or less. In group 1 local pressure was applied by use of gauze soaked with tranexamic acid, and in group 2 gauze without tranexamic acid was used. Absorbable hemostatic sponges and cross sutures were used as a standard hemostatic measure.
RESULTS
In the 23 patients included in this study, 84 simple extractions were performed during 35 dental surgical procedures. The main preoperative blood tests found the following: a mean hematocrit level of 34.54% (SD, 5.84%; range, 21.7%-44.4%), platelet counts from 31,000/mm(3) to 160,000/mm(3), and a mean INR of 1.50 (SD, 0.39; range, 0.98-2.59). Postoperative bleeding occurred during only 1 procedure (2.9%), and local pressure with gauze was effective for achieving hemostasis. No statistically significant difference in the time to hemostasis was found between the 2 groups.
CONCLUSIONS
This study found a low risk of bleeding for tooth extractions in patients with liver cirrhosis, INRs of 2.50 or less, and platelet counts of 30,000/mm(3) or greater. Blood transfusions were not needed, and in the case of postoperative bleeding, the use of local hemostatic measures was satisfactory.

Links

Publisher Full Text

Authors

Perdigão JP, de Almeida PC, Rocha TD, Mota MR, Soares EC, Alves AP, Sousa FB

Institution

School of Dentistry, Federal University of Ceará, Fortaleza, Brazil.

Source

Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons 70:3 2012 Mar pg e177-84

MeSH

Adult
Antifibrinolytic Agents
Cross-Sectional Studies
Dental Care for Chronically Ill
Female
Hemostatic Techniques
Humans
International Normalized Ratio
Liver Cirrhosis
Liver Transplantation
Male
Middle Aged
Oral Hemorrhage
Platelet Count
Postoperative Hemorrhage
Preoperative Care
Pressure
Prospective Studies
Tooth Extraction
Tranexamic Acid
Treatment Outcome
Young Adult

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

22374059