Immediate laser-induced hemostasis in anticoagulated rats subjected to oral soft tissue surgery: a double-blind study

Abstract

Given the growing trend towards medical indications for continuous use of anticoagulants, the number of patients on these medications continues to rise. The management of patients on oral anticoagulants requiring oral surgical procedures has aroused much controversy. Changes in an anticoagulation regimen are associated with an increased risk of thromboembolism. However, it seems logical and advantageous for the patients' health if surgery could be performed without any change to the anticoagulation therapy. In dentistry, high-power lasers have been poorly explored in this field. The hemostatic properties of high-power lasers could be helpful during oral soft tissue surgeries in anticoagulated patients. The aim of this study was to compare bleeding time in anticoagulated rats after lingual frenectomy performed with a scalpel or diode laser with bleeding time in healthy animals. Twenty-four male Wistar rats were assigned to four groups (n = 6): (CS) Control-Scalpel Surgery; (AS) Anticoagulated-Scalpel Surgery; (CL) Control-Laser (diode laser 810 nm/1.5 W) Surgery; and (AL) Anticoagulated-Laser Surgery (diode laser 810 nm/1.5 W). Warfarin administration was used to induce anticoagulation. Blood was blotted every 30 seconds with filter paper until bleeding stopped to verify bleeding time. Two blinded researchers performed the surgeries and collected the bleeding time data. Diode laser surgery led to complete hemostasis in rats during and after lingual frenectomy. Zero bleeding was assessed during surgeries and after diode laser surgeries in anticoagulated rats. Laser-induced hemostasis offered an alternative solution to the controversial issue of intraoperative and postoperative bleeding control in patients on anticoagulation therapy.

Hand-assisted laparoscopic partial ovariohysterectomy in a standing mare suffering from a bleeding uterine leiomyoma

“…The dilated cervix likely enabled the blood clots in the uterus lumen to drop out at night, and during the hysteroscopy the next day a clear view was obtained without uterus lavage. Haemorrhage was visible on the endometrial surface, but the source of bleeding was obscured by the large mass, which made haemostasis with, for instance, the use of laser technique, an infeasible option (Campos et al 2018).…”

Laser coagulation and hemostasis of large diameter blood vessels: effect of shear stress and flow velocity

“…These RF tools operate at higher input energy/power and are utilized for softtissue cutting and represent commonly employed tools for most surgical procedures. Laser coagulation of blood vessels, however, has limited use in the operating room (OR) for coagulation/hemostasis during conventional surgery, outside of dermal/oral/dental soft tissue surgical applications [13][14][15][16] . One possible reason for underutilization of lasers in the OR relates to the selection of laser dosimetry that offers good hemostasis while providing relatively comparable tissue removal rates to conventional cautery tools.…”