Hemostatic Mouthwashes in Anticoagulated Patients Undergoing Dental Extraction

Patatanian, Edna; Fugate, Susan E.

doi:10.1345/aph.1h295

Cited by 42 publications

(18 citation statements)

References 17 publications

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“…Until then a risk-based approach may be considered. As a result of the relatively low risk of perioperative hemorrhage in the field of cutaneous, dental and cataract surgery the surgical protocols have been changed in favor of perioperative continuation of anticoagulant therapy [1, 7, 11, 14]. The postoperative readjustment of the therapeutic values of INR can be troublesome after discontinuation of AC treatment.…”

Section: Discussionmentioning

confidence: 99%

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The perioperative use of oral anticoagulants during surgical procedures for carpal tunnel syndrome. A preliminary study

Tewarie

Bartels

2010

Acta Neurochir

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BackgroundTo evaluate the feasibility of designing a randomized controlled study whether open carpal tunnel release (OCTR) surgery can be performed safely under systemic anticoagulant therapy using acetylsalicylacid (ASA) or acenocoumarol (ACM), this preliminary, observational study was performed.MethodsProspectively, during 1 year, data were collected from all patients who underwent conventional OCTR at the neurosurgical department of the Canisius Wilhelmina Hospital, Nijmegen, The Netherlands. Patients continued anticoagulant treatment perioperatively.ResultsA total of 364 patients were operated on, of whom 45 continued ASA and seven ACM treatment. Only one patient using ASA complained of a postoperative subcutaneous hemorrhage. In the control group without anticoagulants, none of the patients had a bleeding postoperatively.ConclusionContinuation of anticoagulant treatment is safe for OCTR. The adverse effects of stopping treatment for surgery can be severe. As a result of this study, we have changed our surgery protocol for OCTR and continue anticoagulant treatment perioperatively.

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Section: Discussionmentioning

confidence: 99%

“…There is no clear consensus regarding the perioperative management of AP or AC treatment for a OCTR surgical procedure. Continuation of AP or AC treatment for small surgery has been proven safe for several indications in the field of cutaneous [1, 11], dental [14] and cataract surgery [7]. …”

Section: Introductionmentioning

confidence: 99%

The perioperative use of oral anticoagulants during surgical procedures for carpal tunnel syndrome. A preliminary study

Tewarie

Bartels

2010

Acta Neurochir

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“…Toutefois, de nombreux travaux [12,13,[23][24][25][26][27][28], ainsi que cette étude, ont confirmé que le risque de saignement chez les patients sous AVK n'était pas en relation avec l'intensité de l'hypocoagulabilité sanguine. Cependant, l'alternative proposée, lorsque l'INR est supérieur à 4, demeure le relais par l'héparine, après hospitalisation du malade [21].…”

Section: Discussionunclassified

Techniques d’hémostase locale en chirurgie buccale pour les patients sous anticoagulants : étude prospective sur 800 actes

Boukais

Zerrouki

Daïmellah

et al. 2010

Med Buccale Chir Buccale

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“…À noter que l'acide tranexamique dans cette indication hémostatique n'a pas été évalué pour les patients sous AAP mais pour les patients sous AVK [15,19]. Les matériaux hémostatiques utilisés sont synthétiques (colle cyanoacrylate, mèches d'oxycellulose).…”

Section: Protocole D'hémostaseunclassified

Avulsions dentaires chez les patients sous clopidogrel : étude prospective bi-centrique

Baranes

Princ

Spaulding

et al. 2016

Med Buccale Chir Buccale

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Résumé -Introduction :Le clopidogrel est un agent antiplaquettaire (AAP) indiqué dans la prévention de l'athé-rothrombose et des thromboses de stents coronaires. Il augmente le risque hémorragique lors des actes chirurgicaux. Son arrêt, même transitoire, peut entraîner un accident thrombotique aigu potentiellement grave. Sujets et méthodes : Une étude prospective bicentrique était réalisée. L'objectif était d'évaluer le risque hémorragique postavulsionnel chez des patients des deux sexes, sans limite d'âge, sous clopidogrel en monothérapie ou bithérapie, bénéficiant d'une hémostase à base de colle chirurgicale. Les critères de non-inclusion étaient les patients ayant bénéficié d'un relais (héparine, flubiprofène) ou ayant arrêté leur traitement anti-agrégant. Quatre-vingt-neuf patients étaient inclus, 128 interventions réalisées, 284 dents extraites. Résultats : Douze épisodes hémorra-giques post-opératoires (9,5 %) étaient constatés dont 11 stoppés par le patient à domicile par compressions avec de l'acide tranexamique à 10 %. Deux tiers des hémorragies (8/12) concernaient des patients sous bithérapie antiagrégante. Un patient présentait une hémorragie persistante ayant nécessité une reprise de l'hémostase au fauteuil. Discussion : Cette étude confirme qu'un protocole d'hémostase locale adapté permet de réaliser les avulsions avec maintien du clopidogrel qu'il soit ou non associé à un autre AAP. En cas de bithérapie, les procédures d'hémos-tase doivent être renforcées. Conclusion : Ces résultats confirment les recommandations de la Société française de chirurgie orale (SFCO).Abstract -Dental avulsions in patients receiving clopidogrel: prospective bicentric study. Introduction: Clopidogrel is an antiplatelet drug used in the prevention of atherothrombosis and thrombosis after coronary stent implantation. It increases the risk of bleeding during surgical procedures. In 2015, the French Society of Oral Surgery (SFCO) published a practice guideline which clearly stated that "interruption of clopidogrel before a surgical procedure is not justified". However, there is limited data on tooth avulsions in patients receiving clopidogrel. Subjects and Methods: A prospective bicentric study was performed. The objective was to evaluate the risk of bleeding after tooth avulsion with an hemostatic procedure including surgical glue, in patients treated with clopidogrel alone or associated with aspirin. Patients under switch treatment (heparine, flurbiprofen) or who interrupted their treatment were not included in this study. 99 patients were included, 128 surgical procedures performed and 284 teeth extracted (2 ± 1 per intervention). Results: 12 post-surgical haemorrhages, 11 of which stopped by patient at home by compression with 10% tranexamic acid where noted. 2/3 of these haemorrhage concerned occurred in patients receiving dual antiplatelet therapy. Only one patient required a new local hemostasis procedure at hospital without transfusion or hospitalisation. Discussion: According to these results discontinuation of clopi...

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Hemostatic Mouthwashes in Anticoagulated Patients Undergoing Dental Extraction

Cited by 42 publications

References 17 publications

The perioperative use of oral anticoagulants during surgical procedures for carpal tunnel syndrome. A preliminary study

The perioperative use of oral anticoagulants during surgical procedures for carpal tunnel syndrome. A preliminary study

Techniques d’hémostase locale en chirurgie buccale pour les patients sous anticoagulants : étude prospective sur 800 actes

Avulsions dentaires chez les patients sous clopidogrel : étude prospective bi-centrique

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