The Use of a Chitosan-Derived Hemostatic Agent for Postextraction Bleeding Control in Patients on Antiplatelet Treatment

Abstract

The current approach for tooth extraction in patients receiving antiplatelet treatment requires the use of local hemostatic agents without previous thromboembolic treatment interruption. The aim of the present study was to evaluate the effectiveness of an extra-alveolar hemostatic agent, the HemCon Dental Dressing (HDD), in controlling postsurgical bleeding. Routine, atraumatic tooth extractions were performed in a single session under local anesthesia without a vasoconstrictor and without interruption of antiplatelet therapy. All patients underwent extraction of 2 teeth in the same session, with each in a different dental hemi-arch, and the hemostatic method to be used was randomly chosen: in the test site, the HDD was applied, whereas in the control site, a common hemostatic sponge (CollaPlug, Zimmer Dental) was applied and stabilized in situ with a suture. For each surgery, 2 different times were measured: the time required for hemostatic agent application and the time required for hemostasis achievement. Postoperative pain and healing quality also were evaluated. Twenty outpatients were enrolled. The mean application time was considerably shorter in the test group than in the control group; the mean bleeding time in the control group was considerably shorter than in the test group; pain values were lower in the test group than in the control group, especially at suture removal; and postextraction socket healing was better in the test group than in the control group. HDD seems to be a valid and safe alternative in treating postextraction sockets in outpatients under single-drug antiplatelet treatment in the absence of surgical wound lacerations.