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Volume 4 Issue 4 (July - August, 2016)
Original Articles
ANALYSIS OF COMPLICATIONS IN ORAL SURGICAL PROCEDURES IN LIVER TRANSPLANT PATIENT- A CLINICAL STUDY | |
Atul P.S Kushwah, Divya Singh Tomar, Akhilesh P.S. Tomar, Ravish Ahuja | |
Back Ground: The aim of this prospective study was to evaluate the incidence of postoperative bleeding after dental extraction in candidates for liver transplantation. Material & Methods: 252 liver transplanted patients were included in this study. Patients were included in the analysis when the blood examinations showed a platelet count of 30,000/mm3 or greater and an international normalized ratio (INR) of 3.0 or less. In group 1 local pressure was applied by use of gauze soaked with tranexamic acid, and in group 2 gauze without tranexamic acid was used. Absorbable hemostatic sponges and cross sutures were used as a standard hemostatic measure. Results: In the 252 patients included in this study, 148 simple extractions were performed during 105 dental surgical procedures. The main preoperative blood tests such as hematocrit level, platelet counts and a mean INR were calculated. Postoperative bleeding occurred during only 1 procedure (2.8%), and local pressure with gauze was effective for achieving hemostasis. No statistically significant difference in the time to hemostasis was found between the 2 groups. Conclusions: This study found a low risk of bleeding for tooth extractions in patients with liver cirrhosis, INRs of 2.50 or less, and platelet counts of 30,000/mm3 or greater. Blood transfusions were not needed, and in the case of postoperative bleeding, the use of local hemostatic measures was satisfactory. |
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