Platelet-rich plasma treatment and hemostasis in patients with hemorrhagic risk.
OBJECTIVE
Our research aimed to evaluate the risk of haemorrhage following oral surgical operations, in patients who were undergoing an anticoagulant therapy, and to test the usefulness of the autologous platelet gel in order to control haemostasis.


METHODS
A total of 208 patients (84 males/124 females) undergoing an anticoagulant therapy and submitted to oral surgery, were divided at random into 4 groups (A, B, C, D) consisting of 52 patients each, using as criterion of differentiation the kind of treatment we adopted in order to get haemostasis. The patients belonging to the first 3 groups (A, B, C), underwent a surgical operation without discontinuing the dicumarol therapy. In order to get haemostasis, we used: platelet-rich plasma (PRP) and suture, in group A; PRP, haemostatic sponges and suture, in group B; haemostatic sponges, suture and compression by means of gauzes soaked in tranexamic acid in group C. Group D, instead, consisted of patients who underwent a surgical operation, before which the dicumarol therapy had been suspended and replaced by heparincalcium.


RESULTS
Patients belonging to the groups A and B showed a very good haemostasis like the patients of group D (control group). As the coumarin therapy didn't need to be discontinued some days before the surgical operation, so the days of hospital stay were reduced and there wasn't the risk of thromboembolism. As to group C (19 males), 6 patients (i.e. 11.5%) showed a good haemostasis, both at once and in the long term, so that they could be discharged on day 2 after surgery.


CONCLUSIONS
The results obtained during our research, highly encourage using PRP regularly when carrying out surgical treatments on patients who are undergoing a coumarin therapy.
Giuffrè
G
G
Unit of Maxillofacial Surgery and Odontostomatology, San Sebastiano Hospital, Caserta, Italy.
Caputo
G
G
Misso
S
S
Peluso
F
F
D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects; D001728:Dicumarol / Q000009:adverse effects; D005260:Female; D006489:Hemostatic Techniques; D006801:Humans; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000009:adverse effects; D053657:Platelet-Rich Plasma; D019106:Postoperative Hemorrhage / Q000139:chemically induced / Q000628:therapy*; D012307:Risk Factors
D000925:Anticoagulants; D001728:Dicumarol