title: Tranexamic acid mouthwash--a prospective randomized study of a 2-day regimen vs 5-day regimen to prevent postoperative bleeding in anticoagulated patients requiring dental extractions.
abstract: This prospective randomized study analyses the use of a prescribed 4.8% tranexamic acid post-operative mouthwash over 2 days vs 5 days to prevent bleeding in patients taking warfarin who require dental extractions. Eighty-five patients therapeutically anticoagulated with warfarin for various conditions, ranging in age from 21 to 86 years and requiring dental extractions, were randomly divided into two groups. Group A postoperatively received a 4.8% tranexamic acid mouthwash to be used over a 2-day period. Group B received the same mouthwash and instructions postoperatively, to be taken over 5 days. All procedures were performed on an ambulatory basis under local anaesthetic by the same surgeon. Patients were reviewed 1, 3, and 7 days postoperatively to assess bleeding. Eighty-two of the 85 patients encountered no postoperative problems. Two patients in group A and one in group B had minor postoperative bleeds that required minor ambulatory intervention to control. This study shows that a 2-day postoperative course of a 4.8% tranexamic acid mouthwash is as equally effective as a 5-day course in controlling haemostasis post-dental extractions in patient's anticoagulated with warfarin.
authors.affiliation: Oral and Maxillofacial Surgery Unit, University of Adelaide, Adelaide, South Australia.
authors.forename: G
authors.initials: G
authors.lastname: Carter
authors.forename: A
authors.initials: A
authors.lastname: Goss
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects; D000933:Antifibrinolytic Agents / Q000008:administration & dosage*; D017742:Dental Care for Chronically Ill; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000008:administration & dosage*; D006472:Oral Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D019338:Polypharmacy; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D016037:Single-Blind Method; D013997:Time Factors; D014081:Tooth Extraction; D014148:Tranexamic Acid / Q000008:administration & dosage*; D014859:Warfarin / Q000009:adverse effects
chemical_list: D000925:Anticoagulants; D000933:Antifibrinolytic Agents; D009067:Mouthwashes; D014859:Warfarin; D014148:Tranexamic Acid