Prevention of postoperative bleeding in anticoagulated patients undergoing oral surgery: use of platelet-rich plasma gel.
OBJECTIVE
This study evaluated the effectiveness of a protocol using platelet-rich plasma (PRP) to prevent bleeding after dental extraction in patients treated with anticoagulant oral therapy.


METHODS
Forty patients with mechanical heart-value replacement who were treated with anticoagulant oral therapy were selected for the study. Each patient was treated with PRP gel placed into residual alveolar bone after extraction without heparin administration after suspension of oral anticoagulant drugs (36 hours).


RESULTS
Only 2 patients reported hemorrhagic complications (5%). Sixteen patients (40%) had mild bleeding that was easy to control with hemostatic topical agents; this mild bleeding terminated completely 1 to 3 days after the surgical procedures. The remaining 22 patients (55%) presented with adequate hemostasis.


CONCLUSIONS
Oral surgery in heart surgical patients under oral anticoagulant therapy may be facilitated with PRP gel. Its use is an advanced and safe procedure. This biological and therapeutical improvement can simplify systemic management and help avoid hemorrhagic and/or thromboembolic complications.
Della Valle
Antonio
A
Department of Dentistry and Surgery, Faculty of Medicine, University of Naples Federico II, Naples, Italy.
Sammartino
Gilberto
G
Marenzi
Gaetano
G
Tia
Mariano
M
Espedito di Lauro
Alessandro
A
Ferrari
Francesca
F
Lo Muzio
Lorenzo
L
D000328:Adult; D000368:Aged; D000539:Alveolar Process / Q000473:pathology; D000925:Anticoagulants / Q000627:therapeutic use*; D005260:Female; D006350:Heart Valve Prosthesis; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D006472:Oral Hemorrhage / Q000517:prevention & control*; D010949:Plasma; D017713:Platelet Transfusion; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D014081:Tooth Extraction; D020390:Tooth Socket / Q000473:pathology; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D006490:Hemostatics; D014859:Warfarin