Hemorrhagic management for tooth extraction in patients receiving anticoagulant therapy. Application of cotton-type atelocollagen.

要旨

It is not uncommon to reduce the dose or to discontinue anticoagulant agents before tooth extraction in patients who are receiving anticoagulant therapy. However, dose reduction or discontinuance of anticoagulant agents can cause complications such as thromboembolism. Recent recommendations to maintain the usual dosage of anticoagulation regimens have increased the importance of developing reliable procedures for local hemostasis. We used cotton-type atelocollagen to fill tooth extraction cavities in 25 patients who were receiving anticoagulant therapy and evaluated its efficacy. The cavity was sutured in 11 patients, but no other specific procedures, such as hemostatic splints, were used. The thrombotest (TT) levels and PT international normalized ratio (INR) before the operation ranged from 10.2% to 40.2% and from 1.44 to 2.89, respectively. Except for one patient in whom the cotton-type atelocollagen was displaced, we successfully performed primary hemostasis in all patients. There was no problematic postoperative hemorrhage.

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