Hemostatic effect of tranexamic acid solution used as mouthwash

Introductions: The oral surgeons are frequently asked to manage patients who are receiving oral anticoagulants. The goal of treatment is to minimize the risk of hemorrhage while continuing to protect the patient against thromboembolism formation. The ordinary treatment includes the interruption of anticoagulant therapy for oral surgery interventions to prevent hemorrhage. However, this practice may logically increase the risk of a potentially life-threatening thromboembolism. Thus, this issue is still controversial. The aim of the study was to evaluate the mouthwash solution (tranexamic acid) as a local haemostatic modality after oral surgery interventions. Methods: To realize the aim 100 individuals who received oral anticoagulants were included. Oral surgery interventions were performed with a reduction in the level of anticoagulant therapy in the first group. Oral surgery interventions were realized in the second group with no change in the level of anticoagulant therapy and with usage the tranexamic acid. After the interventions the surgical field was irrigated with a 5% solution of tranexamic acid in the treatment group whose oral anticoagulants had not been discontinued (second group) and with a placebo solution in the examined for whom the anticoagulant therapy was reduced (first group). Patients were instructed to rinse their mouths with 10 ml of the assigned solution. Results: The analysis showed that there was no significant difference between the two treatment groups in the bleeding incidence after oral surgery interventions. Conclusion: The anticoagulant treatment does not need to be withdrawn before oral surgery provided that local antifibrinolytic therapy is instituted