Evaluation of Post Extraction Hemostasis in Cardiac Patients with Gelatamp Dental Dressing Without Stopping Aspirin and Clopidogrel Therapy

AIM : The aim of the study is to evaluate clinically the use of Gelatamp dental dressing as a hemostatic agent in cardiac patients continuing aspirin and clopidogrel following dental extraction. MATERIALS AND METHODS : A randomized prospective controlled clinical trial was carried out among the cardiac patients attending the Department of Oral and Maxillofacial Surgery, Best Dental Science College, Madurai district to evaluate the post extraction hemostasis without stopping aspirin and/ or clopidogrel therapy. This study was conducted on 88 patients indicated for teeth extraction divided into two equal groups. Study group consisting of 44 patients who received their medicine as usual and extraction was done followed by insertion of gelatamp in the socket and sutured with 3.0 black silk. Control group consisting of 44 patients who also received their medicine and socket is sutured with 3.0 black silk without placing any haemostatic agent into the socket. The post-operative bleeding had been monitored immediately, 5 minutes, 30 minutes, 2 hours, 24 hours and 7th day after extraction in both groups. RESULTS : The incidence of postoperative bleeding was higher in the control group (grade 2, 36/44, 81.8 %) than in the study group (grade 2 15/44, 34.1 %) immediately after extraction. The post-operative bleeding after 5 minutes is also found to be higher in control group (grade 1- 31/44, 70.4 %) compared to study group ( grade 1 – 12/44, 27.2%) but the difference was statistically not significant. In 30 minutes after extraction the bleeding was very less in study group (grade 1- 1/44, 2.3 %) when compared to control group. No life-threatening complications were reported and no transfusions were required. CONCLUSION : Gelatamp is an effective alternative local hemostatic agent after extraction in cardiac patients (within the therapeutic range of INR) without interruption of the apirin and clopidogrel therapy