The Journal of Korea Assosiation for Disability and Oral Health (대한장애인치과학회지)

Korean Association for Disability and Oral Health (대한장애인치과학회)
권호 표지
DOI QR코드

DOI QR Code

BLEEDING & INFECTION CONTROL BY THE PACKING AND DRAINAGE ON BLEEDING EXTRACTION SOCKET BEFORE BONE MARROW TRANSPLANTATION IN A MULTIPLE DISABLED PATIENT WITH ANTICOAGULATION DRUG : REPORT OF A CASE

항응고제 투여중인 다발성 장애환자에서 골수이식전 발치창 출혈부의 전색과 배농술을 통한 출혈과 감염의 조절 : 증례보고

  • Yoo, Jae-Ha (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University(Wonju Christian Hospital)) ;
  • Son, Jeong-Seog (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University(Wonju Christian Hospital)) ;
  • Kim, Jong-Bae (Department of Dentistry (Oral and Maxillofacial Surgery), Dong San Medical Center, College of Medicine, Keimyung University)
  • 유재하 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원)) ;
  • 손정석 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원)) ;
  • 김종배 (계명대학교 의과대학 동산의료원 치과(구강악안면외과))
  • Received : 2012.05.17
  • Accepted : 2012.06.11
  • Published : 2012.06.29
Download PDF
⟨ Previous Next ⟩

Abstract

Extraction of all nonrestorable teeth prior to bone marrow transplantation is the major dental management of the patient being prepared for the transplantation. But, there are four principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (3) Thrombocytopenic purpuras (4) Disorders of coagulation (liver disease, anticoagulation drug-heparin, coumarin, aspirin, plavix) If the hemorrhage from postextraction wound is unusually aggressive, the socket must be packed with local hemostatic agent and wound closure & pressure dressing are applied. But, in dental alveoli, local hemostatic agent (gelfoam, surgcel etc) may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding and infection control by suture, pressure packing and iodoform gauze drainage on infected active bleeding extraction socket under sedation and local anesthesia in a 57-years-old multiple disabled patient with anticoagulation drug.

Keywords

References

  1. Little JW and Falace DA: Dental management of the medically compromised patient, Sixth edition. Saint Louis, CV Mosby. 332-364, 501-525, 2002.
  2. Sonis ST, Fazio RC and Fang L : Principles and practice of oral medicine. Second edition. Philadelphia, WB Saunders. 242-275, 1995.
  3. Heimdahl A : The oral cavity as a port of entry for early infections in patients treated with bone marrow transplantation, Oral Surg 68:711-716, 1989. https://doi.org/10.1016/0030-4220(89)90160-6
  4. Rhodus NL, Little JW : Dental management of the bone marrow transplantation patient. Comp Cont Educ Dent 13:1040-1052, 1992.
  5. Conley JJ : Complications of head and neck surgery. Philadelphia, WB Saunders. 66-80, 1979.
  6. Falace DA : Emergency dental care. Baltimore, Williams and Wilkins. 227-253, 1995.
  7. 김진복, 김춘규, 이용각, 장선택 : 최신 외과학, 제 1판. 서울, 일조각. 21-51, 1987.
  8. 의학교육연수원 편 : 의학연수교육총서 제 1집, 증보판 응급처치. 서울, 서울대학교 출판부. 75-100, 1994.
  9. Patton LL and Ship JA : Treatment of patients with bleeding disorders. Dent Clin Nor Am 38:465-482, 1994.
  10. Rodgers GM : Overview of platelet function. Clin Obstet Gynecol 42:349-359, 1999. https://doi.org/10.1097/00003081-199906000-00019
  11. Bonoliel R, Leviner E and Katz J : Dental treatment for the patient on anticoagulant therapy. Oral Surg Oral Med Oral Pathol 62:149-155, 1986. https://doi.org/10.1016/0030-4220(86)90036-8
  12. Kruger GO : Textbook of oral and maxillofacial surgery. Sixth edition. Saint Louis, CV Mosby. 229-254, 1984.
  13. Kelly MA : Common laboratory tests. their use in the detection and management of patients with bleeding disorders. Gen Dent 38:282-285, 1990.
  14. Schardt SD : Update on coagulopathies. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 90:559-563, 2000. https://doi.org/10.1067/moe.2000.110437
  15. Topazian RG and Goldburg MH : Management of infections of the oral and maxillofacial regions. Philadelphia, WB Saunders. 329-350, 1981.
  16. 김경욱, 김경원, 김수관 외 14인 : 구강악안면 감염학, 서울, 지성출판사. 67-139, 2007.
  17. Fonseca RJ and Walker RV : Oral and Maxillofacial trauma, Vol I. Philadelphia, WB Saunders. 58-73, 1991.
  18. 민병일 : 악안면 성형외과학. 서울, 군자출판사. 45-61, 1990.
  19. 강현숙, 문희정, 송경희, 김수관 : 최신 구강악안면외과학. 서울, 고문사. 97-121, 2007.
  20. 최현림, 김수영, 김철환, 신호철, 이혜리, 조경환 등 : 가정의학, 임상편. 서울, 계축문화사. 597-714, 2003.