title: [Hemostatic wound management in marcumar patients. Collagen fleece vs. tranexamic acid].
abstract: A total of 124 patients on oral anticoagulation therapy with coumarin were treated by orosurgical procedures and entered into a study to determine the hemostatic efficiency of different methods. The therapeutic anticoagulation level was determined in accordance with the recommendations of the American Heart Association (low risk: 2.0 < INR < 3.0; high risk: 2.5 < INR < 3.5) and maintained during treatment. In one group, the alveoli were treated with collagen, in a second group a mouthrinse regime with tranexamic acid was implemented. Twenty-three patients had to be excluded because anticoagulation levels differed from the recommended values. The group treated with collagen included 31 patients, the group with tranexamic acid mouthwashes, 32 patients. A third group was analyzed in which a controlled change in the anticoagulation level had been performed and all treated alveoli had been covered by mucosal flaps (n = 38); they were compared to the other two groups. The surgical proceedings were outlined precisely. Patients treated with collagen had a bleeding rate of 19%, patients with tranexamic acid mouthwash 6%, and those treated with mucosal flaps 40%. The data were not suited for statistical evaluation, they were objected to a descriptive analysis: the confidence intervals were determined by tables for binomial distributions. These did confirm the difference in the frequency of bleeding for the tranexamic acid and mucosal flap groups.
authors.affiliation: Klinik für Kiefer- und Gesichtschirurgie, Plastische Operationen, Katharinenhospital, Klinikum Stuttgart, Deutschland.
authors.forename: R
authors.initials: R
authors.lastname: Bublitz
authors.forename: S
authors.initials: S
authors.lastname: Sommer
authors.forename: D
authors.initials: D
authors.lastname: Weingart
authors.forename: K
authors.initials: K
authors.lastname: Bäuerle
authors.forename: A
authors.initials: A
authors.lastname: Both
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000539:Alveolar Process / Q000601:surgery*; D000925:Anticoagulants / Q000009:adverse effects*; D003094:Collagen / Q000008:administration & dosage*; D006488:Hemostasis, Surgical; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D008875:Middle Aged; D010644:Phenprocoumon / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000188:drug therapy; D014081:Tooth Extraction; D014148:Tranexamic Acid / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D006490:Hemostatics; D014148:Tranexamic Acid; D003094:Collagen; D010644:Phenprocoumon