Topical hemostatic agents from an oral-surgery perspective

Ruangchainicom, Nanticha; Mahardawi, Basel; Sakdejayont, Watus

doi:10.1016/j.ajoms.2020.11.007

Cited by 6 publications

(3 citation statements)

References 46 publications

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“…Local hemostatic treatment was administered as follows. The extraction socket was filled with an absorbable hemostat, including a gelatin sponge, oxidized cellulose, and/or fibrin glue 16 . and a custom‐made mouth splint was worn continuously for 7 days after intervention, with removal only for oral care, if it was not uncomfortable 13,17 …”

Section: Methodsmentioning

confidence: 99%

Peri‐operative hemostatic management of tooth extraction in patients with hemophilia A, with and without inhibitors, receiving emicizumab prophylaxis

et al. 2022

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Introduction: Emicizumab treatment may allow patients with hemophilia A without (PwHA) and with inhibitors (PwHA-I) to undergo some minor surgeries, such as tooth extraction, without peri-operative factor infusions. However, criteria for determining the necessity of factor infusions before minor surgeries are unknown. Aim:We report the peri-operative hemostatic management and outcomes of emicizumab-treated PwHA and PwHA-I cases who underwent tooth extractions using our institutional protocol. Methods: We retrospectively evaluated PwHA and PwHA-I who underwent tooth extraction with emicizumab prophylaxis at our institution. Local bleeding risk was assessed based on the method, number, and site of tooth extraction. Hemostasis was monitored peri-operatively by rotational thromboelastometry (ROTEM). Hemostatic agents and a mouth splint were used. Results: Twenty-nine extractions (17 interventions) were performed in eight PwHA and two PwHA-I. Based on ROTEM, pre-operative factor infusions were used in ten PwHA and four PwHA-I interventions. Among nine low local bleeding risk interventions, three (33.3%) each received no infusions, one dose of factor infusion pre-operatively, and pre-and post-operative factor infusions. All eight high local bleeding risk interventions involved planned factor infusions. Absorbable hemostats were used in all extractions. A mouth splint was used in 21/25 (84.0%) PwHA and in 4/4 (100%) PwHA-I extractions. No post-extraction bleeding or thrombotic events occurred.Conclusions: Use of a systemic hemostatic treatment plan according to the local bleeding risk, peri-operative coagulation status assessment using ROTEM, filling the extraction socket with hemostats, and use of a mouth splint can achieve effective and safe hemostatic management in emicizumab-treated PwHA and PwHA-I.

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Section: Methodsmentioning

confidence: 99%

Peri‐operative hemostatic management of tooth extraction in patients with hemophilia A, with and without inhibitors, receiving emicizumab prophylaxis

et al. 2022

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“…[ 4–6 ] Mechanical means (sutures and staples), electrosurgery, and hemostatic agents are the major clinical methods for hemostasis and wound sealing. [ 7–10 ] However, surgical sutures and staples as current standards for hemostasis and wound sealing, can mechanically harm tissues and are prone to dehiscence, leakage, and inflammation. [ 11 ] Electrosurgery allows for dissection, adhesiolysis, and division of vascular structures in a short time; however, it is not suitable for diffuse small vessel bleeding or bleeding near vital structures and can cause thermal damage, devascularization, and tissue necrosis.…”

Section: Introductionmentioning

confidence: 99%

A Laparoscopically Compatible Rapid‐Adhesion Bioadhesive for Asymmetric Adhesion, Non‐Pressing Hemostasis, and Seamless Seal

Yang,

Wang,

Yang

et al. 2024

Adv Healthcare Materials

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Bioadhesive hydrogels have offered unprecedented opportunities in hemostatic agents and tissue sealing, however the application of existing bioadhesive hydrogels through narrow spaces to achieve strong adhesion in fluid‐rich physiological environments is challenged either by undesired indiscriminate adhesion or weak wet tissue adhesion. Here we propose a laparoscopically compatible asymmetric adhesive hydrogel (aAH) composed of sprayable adhesive hydrogel powders and injectable anti‐adhesive glue to hemostasis and seal the bloody tissues in a non‐pressing way, allowing for preventing postoperative adhesion. The powders can seed on the irregular bloody wound to rapidly absorb interfacial fluid, crosslink, and form an adhesive hydrogel to hemostatic seal (blood clotting time and tissue sealing in 10 s, approximately 200 mmHg of burst pressure in sealed porcine tissues). The aAH can be simply formed by crosslinking the upper powder with injectable glue to prevent postoperative adhesion (adhesive strength as low as 1 kPa). The aAH outperforms commercial hemostatic agents and sealants in the sealing of bleeding organs in live rats, demonstrating superior anti‐adhesive efficiency. Furthermore, the hemostatic seamless sealing by aAH succeeds in shortening the time of warm ischemia, decreasing the blood loss and reducing the possibility of rebleeding in the porcine laparoscopic partial nephrectomy model.This article is protected by copyright. All rights reserved

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“…Hemostatic agents have been introduced as a method to secure better hemostasis. Several agents were presented and compared, whether with conventional measures or with other agents 13 . Yet, the best agent among all the available options is still undetermined.…”

Section: Introductionmentioning

confidence: 99%

The effect of different hemostatic agents following dental extraction in patients under oral antithrombotic therapy: a network meta-analysis

Mahardawi

Jiaranuchart

Arunjaroensuk

et al. 2023

Sci Rep

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This network meta-analysis was done to thoroughly evaluate the available literature on the use of different hemostatic agents for dental extraction in patients under oral antithrombotic therapy, aiming to identify the agent with the best/worst performance in bleeding control. Considering that such patients have a higher risk of bleeding, choosing the right hemostatic is essential. Twenty-three randomized clinical trials articles were included after completing the literature search. Cyanoacrylate tissue adhesive showed a reduction in the odds of postoperative bleeding events compared with conventional methods (i.e., gauze/cotton pressure, sutures), with a tendency toward a statistical significance (OR 0.03, P = 0.051). Tranexamic acid was the only agent that demonstrated a significantly lower risk of developing postoperative bleeding events (OR 0.27, P = 0.007). Interestingly, chitosan dental dressing and collagen plug had the shortest time to reach hemostasis. However, they ranked last among all hemostatic agents, regarding bleeding events, revealing higher odds than conventional measures. Therefore, it is concluded that the use of cyanoacrylate tissue adhesive and tranexamic acid gives favorable results in reducing postoperative bleeding events following dental extractions. Although chitosan dental dressing and collagen exhibited a faster time to reach hemostasis, they led to a higher occurrence of bleeding events.

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Topical hemostatic agents from an oral-surgery perspective

Cited by 6 publications

References 46 publications

Peri‐operative hemostatic management of tooth extraction in patients with hemophilia A, with and without inhibitors, receiving emicizumab prophylaxis

Peri‐operative hemostatic management of tooth extraction in patients with hemophilia A, with and without inhibitors, receiving emicizumab prophylaxis

A Laparoscopically Compatible Rapid‐Adhesion Bioadhesive for Asymmetric Adhesion, Non‐Pressing Hemostasis, and Seamless Seal

The effect of different hemostatic agents following dental extraction in patients under oral antithrombotic therapy: a network meta-analysis

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