Evaluation of Fibrin Sealants and Tissue Adhesives in Oral Surgery for Patients with Bleeding Disorders

Abstract

Objective: The aim of this study was to evaluate the efficiency of two local hemostatic agents administered with apreoperative dose of replacement therapy in patients with bleeding disorders undergoing oral surgery.Material and Methods: The study included 21 patients that were randomly divided into 3 groups. Patients in Group1 (n = 7) received preoperative replacement therapy and postoperative fibrin sealant applied to the surgical site. Patientsin Group 2 (n = 7) received preoperative replacement therapy and postoperative tissue adhesive applied to the surgicalsite. Patients in Group 3 (n = 7) were given replacement therapy pre- and postoperatively.Results: Postoperative bleeding was not observed in 17 of the 21 patients, including 5 in Group 1 (71.42%), 6 in Group2 (85.71%), and 6 in Group 3 (85.71%). Hemorrhagic complications occurred in only 4 of the 21 patients.Conclusion: The use of fibrin sealant and tissue adhesive was beneficial, as they reduced the level of factor concentratesused for replacement therapy and resulted in rapid hemostasis at the surgical site, facilitating the ability to performserial surgical procedures concurrently.

Interventions for treating post-extraction bleeding

“…The study evaluated the e icacy of suturing and the e ect of warfarin on prevention of post-extraction bleeding. Ak 2012;Carter 2003;Howard 1973;Henderson 1998;Pinsent 1986; CTRI/2017/09/009784; NCT02918045; NCT03108365 and Zhou 1985 were preventive trials. Kjellman 1973 assessed pain management a er removal of impacted third molars.…”

Risk factors for post-extraction bleeding in patients with haemophilia: a retrospective cohort study

“…These findings are in accordance with previously reported figures, which range from 1.9% to 31.5%. 6,7,10,14,15 However, the discrepancy between reported values may relate to the use of different definitions of post-extraction bleeding. A retrospective study using the same definition for post-extraction bleeding as in this study reported that the incidence of post-extraction bleeding for patients receiving anticoagulants and those not receiving anticoagulants was no more than 11% and 0.9%, respectively.…”

“…Our multivariate logistic regression analysis revealed that use of mouth splints significantly decreased the risk of post-extraction bleeding in haemophilia patients. Previous literature and guidelines have recommended the use of mouth splints in haemophilia patients 3,4,10,13 and patients on antithrombotic therapy, 18 because it prevents the tongue from scratching the inside of the extraction socket and protects the blood clot beneath it. However, we believe our study is the first to have used statistical methods to support the preventive effect of mouth splints J o u r n a l P r e -p r o o f for post-extraction bleeding in haemophilia patients.…”

“…Previous studies and current guidelines have described various haemostatic management protocols that use systemic and local haemostatic measures. [3][4][5][6][7][8][9][10][11][12][13][14][15][16] Local haemostatic treatment can include the application of a mouth splint, and the use of absorbable haemostats such as oxidised cellulose and fibrin glue is recommended. However, few publications have evaluated risk factors for post-extraction bleeding among such patients.…”

Preparation of biodegradable functionalized polyesters aimed to be used as surgical adhesives

“…fibrin glues [4], collagen adhesives [5,6]), synthetic and semi-synthetic (gelatin-resorcinol-formaldehyde [7], cyanoacrylates [8]) and biomimetics (marine mussel extracts [9]). However, the use of blood derived products such as fibrin has been associated with the risk of diseases transmission, while cyanoacrylates degrade into formaldehyde, which confines their use to external applications [1,10,11]. One possible solution to circumvent these limitations is the development of adhesives based on biodegradable and biocompatible polymers.…”