ABSTRACT
INTRODUCTION: Bleeding after dental surgery is still a common cause for emergency presentation in patients using anticoagulants. Our aim was to analyze pertinent characteristic features on the one hand and to bare existing problems in handling on the other. MATERIALS AND METHODS: The study included 76 patients. We documented basic data, anticoagulant medication, type of surgery, and tooth socket sutures in respective patients. RESULTS: The vast majority of patients took a coumarin derivative (41) and acetylsalicylic acid (27). Nine (12%) of the patients had to be hospitalized due to ongoing bleeding despite local haemostyptic steps and/or circulatory dysregulation. Most patients could be successfully treated in outpatient settings. No statistically significant correlation between bleeding, level of INR value, number of extracted teeth, and sewed alveoli could be shown. Sixty-five percent of cases with tooth extractions did not have suture of tooth sockets. Eighty-seven percent of the patients denied being informed about possible self-treatment options by their surgeon/dentist, and none of the patients got presurgical-fabricated bandage plate(s). CONCLUSIONS: Patients taking coumarin derivative currently, furthermore, represent the biggest anticoagulant after-bleeding group in dentoalveolar surgery. The major part of after-bleedings (90%) can be handled in an outpatient setting with simplest surgical interventions. Unfortunately, the biggest part of the patient collective got no suture, no prefabricated dental bandage plate(s), and no explanation by their dentist how to handle in case of after-bleeding. Therefore, dental practitioners should furthermore get enlightenment on how to prevent after-bleeding situations.
ABSTRACT
OBJECTIVES: The aim of this prospective study was to determine laboratory parameters predicting complications and/or failure in flap surgery. STUDY DESIGN: Fifty-seven patients undergoing reconstructive surgery with cutaneous free and pedicled flaps were included. Blood samples were taken 2 days before surgery and 1, 3, 5, 7, and 14 days after. Parameters associated with thrombophilia, bleeding disorders, and wound healing were determined. RESULTS: In 45 (77%) of 57 patients no complications occurred. Bleeding (9%) and venous thrombosis of the flaps (9%) led in 18% of the cases to surgical revisions. Activated protein C resistance showed a significant (P < .05) cluster in cases with venous thrombosis, whereas it was absent in all other cases. Fibrinogen, factor VIII:C, von Willebrand factor (vWF) activity, and VWF antigen were significantly (P < .05) higher in patients with venous thrombosis compared with all other patients. CONCLUSIONS: Laboratory parameters of thrombosis and bleeding appear to be associated with complications in flap surgery.
Subject(s)
Plastic Surgery Procedures , Postoperative Complications , Surgical Flaps , Activated Protein C Resistance/etiology , Blood Coagulation Tests , C-Reactive Protein/analysis , Factor VIII/analysis , Female , Fibrinogen/analysis , Follow-Up Studies , Forecasting , Free Tissue Flaps/adverse effects , Hematologic Tests , Hemorrhagic Disorders/blood , Humans , Male , Necrosis , Platelet Function Tests , Postoperative Hemorrhage/etiology , Prospective Studies , Plastic Surgery Procedures/adverse effects , Reoperation , Skin Transplantation/adverse effects , Surgical Flaps/adverse effects , Thrombophilia/blood , Thrombosis/blood , Thrombosis/etiology , Venous Thrombosis/blood , Venous Thrombosis/etiology , von Willebrand Factor/analysis , von Willebrand Factor/immunologyABSTRACT
The volume required for the rheological characterization of fluids can beminimized by using micromechanical cantilevers as viscosity sensors. Here, a simplemeasurement tool for the characterization of sugar solutions is proposed. The sensorconsists of a micromechanical cantilever as used in an atomic force microscopy which isintegrated into a closed fluid handling system. Fluid properties are derived from an analysisof the power spectral density of the fluctuations of the cantilever deflection signal. The dataacquisition system is operated with standard consumer computer components, which limitsthe costs for the hardware. Measurements with different sugar solutions indicate that thesensor system provides reliable viscosity values for sugar concentrations as they occur inbiological systems. The viscosities of the sugar solutions could be evaluated with an errorsmaller than 5 %.
