MANAGEMENT OF POST-OPERATIVE BLEEDING

Prolonged bleeding after dental extraction:  MC sign of hemorrhagic disease  Can be the way to first recognized bleeding tendency

Management of Post-Operative Bleeding Discover the precise site/origin of the bleeding cleaning out the mouth with swabs pressing firmly with gauze pad over the socket for min  stop bleeding but often only temporary suture the socket under LA If bleeding persists, consider a systemic cause such as: 1.Acquired deficiencies of hemostasis, such as anticoagulants or thrombocytopenia 2.Hereditary deficiencies of clotting factors (e.g: Von Willebrand syndrome and haemophilia)

Patient with bleeding tendency:  A previous diagnosis of a bleeding tendency  Bleeding more than 36h or restarting more than 36h after operation (however, this could indicate an infection)  Admission to hospital to arrest bleeding  Blood transfussion for bleeding  Spontaneous bleeding (e.g: haemarthrosis, deep bruising or menorrhagia from little obvious cause)  Convincing family history of one of the above, combined with a degree of personal history  Treatment with significant drugs such as anticoagulants

Emergencies cases: Established intravenous line Give plasma expanders or blood

Management of Patients with Haemophilia After Dental Treatment  Hospitalize the patient if bleeding is not controlled  Examine the patient hours post procedure: – treat infection and/or bleeding issues  Avoid aspirin, use acetaminophen with or without codeine