title: Tranexamic Acid Tamponade to Control Postoperative Surgical Hemorrhage.
abstract: When preparing for oral surgery, patients taking anticoagulants usually should not discontinue their medication because of the risk of a thromboembolic event. The therapeutic effect of many anticoagulants is not readily measured, so preoperatively, the surgeon cannot know the true risk for postoperative hemorrhage. The risk of a thromboembolic event usually outweighs the concerns of controlling postoperative hemorrhage. Hemophilia patients are also at risk for postoperative bleeding. Single extractions probably do not pose a serious risk for postoperative hemorrhage. However, when a mucogingival flap is raised in these patients, there may be prolonged bleeding. Surgical sponges saturated with aqueous tranexamic acid solution and compressed onto the bleeding site with biting pressure may stop bleeding. Bleeding was stopped in the case example presented here after three 10-minute compressions over 30 minutes in a patient taking aspirin and clopidogrel for a previous thromboembolic event and a metal coronary stent. The clot formed is very fragile and is prone to bleeding, so it should not be disturbed. This technique needs to be studied for efficacy.
authors.affiliation: Private practice, Willimantic, Conn.
authors.forename: Dennis
authors.initials: D
authors.lastname: Flanagan
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D016063:Blood Loss, Surgical / Q000517:prevention & control; D006801:Humans; D019106:Postoperative Hemorrhage; D014081:Tooth Extraction; D014148:Tranexamic Acid / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014148:Tranexamic Acid
keywords: anticoagulants; bleeding; bleeding control; coagulation; dental implant; hemorrhage; local bleeding control; oral bleeding; oral surgery