Evaluating Effectiveness of Axiostat Hemostatic Material in achieving Hemostasis and Healing of Extraction Wounds in Patients on Oral Antiplatelet Drugs

Abstract

Aim:The aim of this study was to evaluate the efficacy of Axiostat Hemostatic Dental dressing in achieving hemostasis postextraction and determining its effect on pain and healing of the extraction wound, compared with control, i.e., conventional method of extraction in patients on oral antiplatelet therapy. Materials and methods:Totally, 40 patients on oral antiplatelet drugs were included in the study and overall 80 extractions were done applying split mouth study design, without altering patient's drug regime. Extraction sites were divided into two groups: Group I received Axiostat Hemostatic Dental Dressing (study site), and group II received conventional method; pressure pack with sterile gauze under biting pressure followed by suturing if required (control site) was used to attain hemostasis. Results: Extraction sites treated with Axiostat HemostaticDressing achieved hemostasis earlier (mean 1 minute 13 seconds) compared with control sites (mean = 14 minutes 1 second), which was also statistically significant (p < 0.001). Postoperative pain was considerably lower and significantly better healing was seen in the study group (p < 0.001) compared with the control. Conclusion:Axiostat demonstrated to be an effective hemostatic agent that considerably lessens the bleeding time in patients on oral antiplatelet drugs postextraction. In addition, it even offered minimal postoperative pain and improved healing of the extraction wound. On comparing the results of this study with our study on HemCon Dental Dressing, Axiostat Dental Dressing (ADD) is found to be as effective and at par in achieving hemostasis in patients on oral antiplatelet therapy. Clinical significance:The past few decades have seen an upsurge in use of low-dose aspirin either alone or in combination with other drugs. When these patients require dental/ maxillofacial treatment, earlier concept of stopping these medications is associated with increased risk of thromboembolic event. The present study highlights an alternative approach using ADD which aids in quick hemostasis, accentuates healing, and reduce postoperative pain.

A comparative evaluation of the effectiveness of chitosan-based dressing and conventional method of hemostasis in patients on oral antithrombotic therapy without therapy interruption

“…Four patients suffered with dry socket on pressure sites; however, no patients had dry socket in chitosan group. This is in accordance to Sharma et al .,[8] Eldibany,[10] and Kale et al . [13]…”

“…Even latest studies do not agree with the concept of stopping OAT and recommended prevention of hemorrhagic complications by means of local hemostatic measures, maintaining therapeutic INR levels. [6789]…”

“…The initial seal gets further strengthened by continuous accumulation of platelets and red blood cells, achieving hemostasis. [678]…”

Advances in Antiplatelet Therapy for Dentofacial Surgery Patients: Focus on Past and Present Strategies

“…A study by Sharma et al evaluated the function of a hemostatic biomaterial after extractions on patients on antiplatelet therapy with a 2017 article. This agent had excellent hemostatic results, lowering both bleeding time and wound healing and, still, postoperative pain, without the need for other drug therapy, compared to the control group [31,39]. A case-crossover study by Akhlaghi et al in 2017 assessed whether there is indeed a higher risk in these patients who underwent surgery.…”

“…The dentist, even in patients undergoing therapy, can perform routine extraction without risk without interrupting or modifying the latter. Patients do not have a greater risk of bleeding, even if they have been in antiplatelet therapy for a long time but, in some cases, as some authors mention in a refined way, the therapy must be personalized for each patient [26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42] Pototski et al in 2007, stated in their work that patients can be treated without risk if their INR is lower than 4.0 [48]. However, other studies assess that the risk of bleeding can be controlled by post-extraction hemostasis maneuvers [49].…”