J Korean Dent Soc Anesthesiol.  2011 Dec;11(2):177-182. 10.17245/jkdsa.2011.11.2.177.

Bleeding & Infection Control by the Circumferential Suture & Drainage on Active Bleeding Extraction Socket under Sedation And Local Anesthesia in a Multiple Medically Compromised Patient with Anticoagulation Drug

• Yoo JH
• Kim JB

• KMID: 2425217
• DOI: http://doi.org/10.17245/jkdsa.2011.11.2.177

Abstract

There are five principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (genetic defect, drug-aspirin, autoimmune disease) (3) Thrombocytopenic purpuras (radiation, leukemia), (4) Inherited disorders of coagulation (hemophilia, Christmas disease, vitamin deficiency, anticoagulation drug-heparin, coumarin, aspirin, plavix). If the hemorrhage from postextraction wound is unusually aggressive, and then dehydration and airway problem are occurred, the socket must be packed with gelatine sponge(Gelfoam) that was moistened with thrombin and wound closure & pressure dressing are applied. The thrombin clots fibrinogen to produce rapid hemostasis. Gelatine sponges moistened with thrombin provide effective coagulation of hemorrhage from small veins and capillaries. But, in dental alveoli, gelatine sponges may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding and infection control by the circumferential suture and iodoform gauze drainage on infected active bleeding extraction socket under sedation and local anesthesia in a 71-years-old male patient with anticoagulation drug.

Keyword

Bleeding extraction socket; Circumferential suture; Iodoform gauze drainage; Anticoagulation drug; Multiple medically compromised patient

MeSH Terms

Anesthesia, Local*
Aspirin
Avitaminosis
Bandages
Blood Platelets
Capillaries
Dehydration
Drainage*
Dry Socket
Fibrinogen
Gelatin
Hemophilia B
Hemorrhage*
Hemostasis
Humans
Infection Control*
Male
Porifera
Purpura, Thrombocytopenic
Scurvy
Sutures*
Thrombin
Veins
Wounds and Injuries
Aspirin
Fibrinogen
Gelatin
Thrombin