Minor oral surgery procedures in patients taking warfarin: a 5-year retrospective study at Sultan Qaboos University Hospital, Sultanate of Oman

ABSTRACT

Minor oral surgery [MOS] procedures in warfarinised patients carry the risk of post-operative bleeding. The aim of this study was to conduct a retrospective analysis and to describe the profile of warfarinised patients who underwent MOS procedures at Sultan Qaboos University Hospital. A retrospective study of 124 warfarinised patients [41 men and 83 women], who had a pre-operative international normalised ratio [INR] of procedures under local anaesthesia, without discontinuation of their warfarin therapy, was carried out over a 5-year period from January 2004 to December 2008. Results: Ninety [72.6%] patients had simple dental extractions, 26 [21%] surgical extractions, 6 [4.8%] soft tissue biopsies and 2 [1.6%] had apicectomies with cyst enucleations. Local measures were applied in all patients, which included the use of oxidizing regenerated cellulose haemostatic agent [Surgicel] and suturing. A total of eight patients [6.5%], five who had surgical extractions and three who had simple extractions, bled enough post-operatively to require a return to hospital. All cases of post-operative bleeding were managed conservatively by repacking the bleeding site with haemostatic agent and re-suturing without the need for hospital admission. Minor oral surgery procedures can be safely conducted in warfarinised patients without interruption of warfarin regimen when the pre-operative INR is measures are used