Journal of the Korean Association of Oral and Maxillofacial Surgeons

  • 제35권6호
  • /
  • Pages.431-436
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  • 2009
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  • 2234-7550(pISSN)
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  • 2234-5930(eISSN)
대한구강악안면외과학회 (The Korean Association of Oral and Maxillofacial Surgeons)
권호 표지

중증 간경변증 환자에서 발치창 과도 출혈부의 지속적 배농술을 통한 지혈 : 증례보고

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

  • 모동엽 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원)) ;
  • 유재하 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원)) ;
  • 최병호 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원)) ;
  • 김하랑 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원)) ;
  • 이천의 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원)) ;
  • 유미현 (부산대학교 치의학 전문대학원 구강병리학교실)
  • Mo, Dong-Yub (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University(Wonju Christian Hospital)) ;
  • Yoo, Jae-Ha (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University(Wonju Christian Hospital)) ;
  • Choi, Byung-Ho (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University(Wonju Christian Hospital)) ;
  • Kim, Ha-Rang (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University(Wonju Christian Hospital)) ;
  • Lee, Chun-Ui (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University(Wonju Christian Hospital)) ;
  • Ryu, Mi-Heon (Department of Oral pathology, School of Dentistry, Yangsan Campus of Pusan National University)
  • 발행 : 2009.12.31
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초록

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.

키워드

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