J Korean Assoc Oral Maxillofac Surg.  2009 Dec;35(6):431-436.

Bleeding Control by Continuous Wound Drainage of Active Bleeding Sites of Teeth Extraction Wound in a Patient with Advanced Liver Cirrhosis: Report of a Case

• Mo DY
• Yoo JH
• Choi BH
• Kim HR
• Lee CU
• Ryu MH

Abstract

There are five principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (genetic defect, drug-aspirin, autoimmune disease) (3) Thrombocytopenic purpuras (radiation, leukemia), (4) Inherited disorders of coagulation (hemophilia, Christmas disease, vitamin deficiency, anticoagulation drug-heparin, coumarin). If the hemorrhage from postextraction wound is unusually aggressive, and then dehydration and airway problem are occurred, the socket must be packed with gelatine sponge(Gelfoam) that was moistened with thrombin and wound closure & pressure dressing are applied. The thrombin clots fibrinogen to produce rapid hemostasis. Gelatine sponges moistened with thrombin provide effective coagulation of hemorrhage from small veins and capillaries. But, in dental alveoli, gelatine sponges may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding control by continuous rubber strip & iodoform gauze drainage (without gelfoam packing) of active bleeding infection sites of three teeth extraction wounds in a 46-years-old female patient with advanced liver cirrhosis.

Keyword

Active oral bleeding; Dental extraction wound; Liver cirrhosis; Continuous wound drainage; Bleeding control

MeSH Terms

Avitaminosis
Bandages
Blood Platelets
Capillaries
Dehydration
Drainage
Dry Socket
Female
Fibrinogen
Gelatin
Gelatin Sponge, Absorbable
Hemophilia B
Hemorrhage
Hemostasis
Humans
Hydrocarbons, Iodinated
Liver
Liver Cirrhosis
Porifera
Purpura, Thrombocytopenic
Rubber
Scurvy
Thrombin
Tooth
Veins
Fibrinogen
Gelatin
Hydrocarbons, Iodinated
Rubber
Thrombin