Comparison of 2 hemostatic agents for the prevention of postextraction hemorrhage in patients on anticoagulants.
OBJECTIVE
The objective of this study was to compare the use of a resorbable oxycellulose dressing with a fibrin adhesive for the prevention of postextraction hemorrhage in patients taking anticoagulants.


METHODS
A control group of 26 patients with a preoperative international normalized ratio (INR) in the range of 2.0 to 4.2 had extractions performed with the use of local anesthesia and the socket(s) dressed with a resorbable oxycellulose dressing and sutured with a resorbable suture. The study group with a comparable INR range of 2.1 to 4.1 was treated in a similar manner, except the sockets were dressed with a fibrin adhesive.


RESULTS
No discernible difference in the postoperative outcome with regard to hemorrhage was noted. Postoperative pain was reported more frequently in the group that used a resorbable oxycellulose dressing. Only 1 patient had significant postoperative bleeding.


CONCLUSIONS
This study shows that in patients receiving warfarin whose INR is within the therapeutic range, the fibrin adhesive is as effective as the resorbable oxycellulose dressing in preventing postextraction hemorrhage.
Halfpenny
W
W
Addenbrookes Hospital, Cambridge, United Kingdom. wayne@whalfpenny.freeserve.co.uk
Fraser
J S
JS
Adlam
D M
DM
D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000766:Anesthesia, Dental; D000772:Anesthesia, Local; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D001458:Bandages; D002483:Cellulose, Oxidized / Q000627:therapeutic use; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D005500:Follow-Up Studies; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D006472:Oral Hemorrhage / Q000517:prevention & control*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D013536:Suture Techniques; D013537:Sutures; D014081:Tooth Extraction / Q000009:adverse effects; D020390:Tooth Socket / Q000187:drug effects; D016896:Treatment Outcome; D014859:Warfarin / Q000008:administration & dosage / Q000627:therapeutic use
D000925:Anticoagulants; D002483:Cellulose, Oxidized; D015718:Fibrin Tissue Adhesive; D006490:Hemostatics; D014859:Warfarin; C013695:Surgicel