Evaluating Effectiveness of Axiostat Hemostatic Material in achieving Hemostasis and Healing of Extraction Wounds in Patients on Oral Antiplatelet Drugs
Saurabh Sharma, Tejraj P Kale, Lingaraj J Balihallimath, Abhishek Motimath
Citation Information :
Sharma S, Kale TP, Balihallimath LJ, Motimath A. Evaluating Effectiveness of Axiostat Hemostatic Material in achieving Hemostasis and Healing of Extraction Wounds in Patients on Oral Antiplatelet Drugs. J Contemp Dent Pract 2017; 18 (9):802-806.
The aim of this study was to evaluate the efficacy of Axiostat Hemostatic Dental dressing in achieving hemostasis postextraction and determining its effect on pain and healing of the extraction wound, compared with control, i.e., conventional method of extraction in patients on oral antiplatelet therapy.
Materials and methods
Totally, 40 patients on oral antiplatelet drugs were included in the study and overall 80 extractions were done applying split mouth study design, without altering patient's drug regime. Extraction sites were divided into two groups: Group I received Axiostat Hemostatic Dental Dressing (study site), and group II received conventional method; pressure pack with sterile gauze under biting pressure followed by suturing if required (control site) was used to attain hemostasis.
Results
Extraction sites treated with Axiostat Hemostatic Dressing achieved hemostasis earlier (mean 1 minute 13 seconds) compared with control sites (mean = 14 minutes 1 second), which was also statistically significant (p < 0.001). Postoperative pain was considerably lower and significantly better healing was seen in the study group (p < 0.001) compared with the control.
Conclusion
Axiostat demonstrated to be an effective hemostatic agent that considerably lessens the bleeding time in patients on oral antiplatelet drugs postextraction. In addition, it even offered minimal postoperative pain and improved healing of the extraction wound. On comparing the results of this study with our study on HemCon Dental Dressing, Axiostat Dental Dressing (ADD) is found to be as effective and at par in achieving hemostasis in patients on oral antiplatelet therapy.
Clinical significance
The past few decades have seen an upsurge in use of low-dose aspirin either alone or in combination with other drugs. When these patients require dental/maxillofacial treatment, earlier concept of stopping these medications is associated with increased risk of thromboembolic event. The present study highlights an alternative approach using ADD which aids in quick hemostasis, accentuates healing, and reduce postoperative pain.
How to cite this article
Sharma S, Kale TP, Balihallimath LJ, Motimath A. Evaluating Effectiveness of Axiostat Hemostatic Material in achieving Hemostasis and Healing of Extraction Wounds in Patients on Oral Antiplatelet Drugs. J Contemp Dent Pract 2017;18(9):802-806.
Oral anticoagulants: Mechanisms of action, clinical effectiveness, and optimal therapeutic range. Chest 1992 Oct;102(4 Suppl):312S-326S.
; Tuddenham, EG. Haemostasis and thrombosis. In: Weatherall DJ, Ledingham JG, Warrell DA, editors. Oxford textbook of medicine. 2nd ed., Vol. 19. Oxford: Oxford Medical Publications; 1988. p. 228-229.
Deep-vein thrombosis. N Engl J Med 1994 Dec;331(24):1630-1641.
Effectiveness of HemCon Dental Dressing versus conventional method of haemostasis in 40 patients on oral antiplatelet drugs. Sultan Qaboos Univ Med J 2012 Aug;12(3):330-335.
Platelet defects of importance in oral surgery. J Oral Surg 1972 Jul;30(7):478-485.
Standardization of the prothrombin time for monitoring orally administered anticoagulant therapy with use of the international normalized ratio system. Mayo Clin Proc 1993 Sep;68(9):897-898.
Frequency and predictors of stroke death in 5,888 participants in the Cardiovascular Health Study. Neurology 2001 Feb;56(3):368-375.
A systematic review and meta-analysis on the hazards of discontinuing or not adhering to aspirin among 50,279 patients at risk for coronary artery disease. Eur Heart J 2006 Nov;27(22):2667-2674.
Hemostasis of oral surgery wounds with the HemCon Dental Dressing. J Oral Maxillofac Surg 2008 Jun;66(6):1177-1183.
A special report on the chitosan-based hemostatic dressing: experience in current combat operations. J Trauma 2006 Mar;60(3):655-658.
Visual analogue measurement of pain. Ulster Med J 1990 Oct;59(2):149-154.
Effectiveness of benzydamyne HCl in the treatment of periodontal post-surgical patients. Research in Clinic Forums. 1988;10:105-118.
Safety and efficacy of Ankaferd blood stopper in dental surgery and bleeding. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;1:1-5.
Discrepant INR values: a comparison between Manchester and Thrombotest reagents using capillary and venous samples. Clin Lab Haematol 1989 Dec;11(4):393-398.
Reliance on prothrombin time ratios causes significant errors in anticoagulation therapy. Arch Intern Med 1992 Feb;152(2):278-282.
The correction of coagulometer effects on international normalized ratios: a multicentre evaluation. Br J Haematol 1994 Jan;86(1):112-117.
J Mater Sci Mater Med 2007 Feb;18(2):195-200.
A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee. Lancet 1996 Nov;348(9038):1329-1339.
Releasing growth factors from activated human platelets after chitosan stimulation: a possible bio-material for platelet-rich plasma preparation. Clin Oral Implants Res 2006 Oct;17(5):572-578.
Prevention of postoperative bleeding in anti-coagulated patients undergoing oral surgery: use of platelet-rich plasma gel. J Oral Maxillofac Surg 2003 Nov;61(11):1275-1278.
Osteogenesis enhanced by chitosan (poly-N-acetyl glucosaminoglycan) in vitro. J Periodontol 1996 Nov;67(11):1170-1175.
Use of chitosan bandage to prevent fatal infections developing from highly contaminated wounds in mice. Biomaterials 2006 Aug;27(22):4157-4164.
Some problems with anticoagulants in dental surgery. Dent Update 1992 Jun;19(5):204-206.
