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Bleeding complications after oral surgery in outpatients with compromised haemostasis: incidence and management

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Abstract

Purpose and results

The aim of this prospective study was to determine the incidence of postoperative bleeding after oral surgery under local anaesthesia performed in outpatients with haemostatic disorders within a 5-year period (2003–2007). One hundred twenty one (70 males, 51 females) out of 2,056 outpatients with different haemostatic disorders (acquired or hereditary) were included in this study. The following data were recorded: medical history and general condition; medications; indication for the surgical procedure; specification of local anaesthesia; applied surgical techniques, considering the kind of haemostatic disorder; and peri- or postoperative bleeding complications. Postoperative bleeding was observed in 12 patients (9.9%). In three cases, inpatient treatment became necessary. The management of two patients with a haemostatic disorder (von Willebrand´s disease and haemophilia A) is presented in short case reports.

Conclusion

In a heterogeneous group of 121 outpatients with known haemostatic disorders, a combination of a few haemostatic agents with appropriate operative technique enables an effective wound management. In cases of failed local interventions after postoperative bleeding, further diagnostic investigations are required.

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Notes

  1. Main contraindications to vasoconstrictors in oral surgery: recent myocardial infarction (within last 6 months), unstable angina pectoris, refractory arrhythmias, untreated or uncontrolled hypertension, recent coronary artery bypass surgery, sulfite-sensitive or cortico-dependent asthma bronchiale, glaucoma congestivum, hyperthyroidism, and phaeochromocytoma. Relative contraindications: patients medicated with tricyclic antidepressants, monoamine oxidase inhibitors, phenothiazines, and beta-blockers [9].

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Authors and Affiliations

  1. Oral and Maxillofacial Plastic Surgery, Martin-Luther-University Halle-Wittenberg, Halle, Germany

    Waldemar Reich

  2. Martin-Luther-University Halle-Wittenberg, Halle, Germany

    Marcus S. Kriwalsky & Johannes Schubert

  3. Center of Internal Medicine, Haematology, Martin-Luther-University Halle-Wittenberg, Halle, Germany

    Hans H. Wolf

Authors
  1. Waldemar Reich
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  2. Marcus S. Kriwalsky
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  3. Hans H. Wolf
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  4. Johannes Schubert
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Correspondence to Waldemar Reich.

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Reich, W., Kriwalsky, M.S., Wolf, H.H. et al. Bleeding complications after oral surgery in outpatients with compromised haemostasis: incidence and management. Oral Maxillofac Surg 13, 73–77 (2009). https://doi.org/10.1007/s10006-009-0154-8

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