MANAGEMENT OF POST-OPERATIVEBLEEDING
Prolonged bleeding after dental extraction:
MC sign of hemorrhagic disease
Can be the way to first recognized bleedingtendency
Management of Post-Operative Bleeding
• Discover the precise site/origin of the bleeding
•cleaning out the mouth with swabs
•pressing firmly with gauze pad over the socket for 10-15 min stop bleeding but often only temporary
•suture the socket under LA
• If bleeding persists, consider a systemic causesuch as:
1.Acquired deficiencies of hemostasis, such asanticoagulants or thrombocytopenia
2.Hereditary deficiencies of clotting factors (e.g:Von Willebrand syndrome and haemophilia)
Patient with bleeding tendency:
A previous diagnosis of a bleeding tendency
Bleeding more than 36h or restarting more than 36h afteroperation (however, this could indicate an infection)
Admission to hospital to arrest bleeding
Blood transfussion for bleeding
Spontaneous bleeding (e.g: haemarthrosis, deep bruising ormenorrhagia from little obvious cause)
Convincing family history of one of the above, combined with adegree of personal history
Treatment with significant drugs such as anticoagulants
Emergencies cases:
•Established intravenous line
•Give plasma expanders or blood
Management of Patients with HaemophiliaAfter Dental Treatment
Hospitalize the patient if bleeding is notcontrolled
Examine the patient 24-48 hours postprocedure:
–treat infection and/or bleeding issues
Avoid aspirin, use acetaminophen with orwithout codeine