local Method To Control Bleeding In Dental Office

1. Local Method To Control
Bleeding In Dental Office
Lena Aloufi

2. Control of bleeding is the most important
integral part of any surgical treatment
procedure.
Proper prior evaluation of the patient &
complete medical and family history are very
much essential to overcome intra operative
& post operative bleeding

3. Methods of hemostasis:
Thermal
energy based
methods
Mechanical
methods
Chemical
methods
Topical
homeostatic
Agent
Others

4. Direct pressure:
Simplest & fastest
Surgeon’s first choice
Fabric pads/gauzes/sponges
Application of direct pressure
Sutures/staples/ligating clips
Sutures and ties used as ligatures to tie off blood
vessels
Ligating clips – quick & easy to apply
Site of application should be clearly visible
Mechanical methods

5. Thermal Based methods
Electro-Surgery:
Use of high frequency alternating current for cutting
coagulating and vaporizing tissues
Lasers
Laser energy delivered to target site can be reflected, scattered,
transmitted or absorbed

6. Chemical methods
Epinephrine
Can be applied topically or injected with local anesthesia
Vitamin K
Administered pre-operatively to reverse effects of warfarin
Protamine
Only agent with ability to reverse heparin anticoagulation

7. Topical homeostatic
Microfibrillar collagen hemostat (Avitene):
Absorbable collagen hemostat sponge (Instat) :
Oxidized regenerated cellulose (Surgical)

8. Topical homeostatic
Gelatins (Gelfoam) :
Derived from purified bovine gelatin solutions
Can be used in dry or wet form
Conforms easily to wounds and therefore can be used for irregular
wounds
Thrombin Product :
- Bovine thrombin:
Applied using a pump or spray kit, or in a saturated,
absorbable gelatin sponge

9. Others
Flowable hemostatic agents:
Combine passive and active hemostatic agents into
a single application product
Work by blocking blood flow & actively converting fibrinogen into fibrin
Selants:
Sealants work by forming a barrier that is impervious to the flow of most
liquids

10. What if the bleeding
presist?

11. Summary

12. References:
1-Mohan, Harsh, Sugandha Mohan, and Harsh Mohan. 2012. Pathology practical
book for dental students.
2- Shafer, William G., Maynard K. Hine, and Barnet M. Levy. 1983. A textbook of oral
pathology. Philadelphia: Saunders.
3- Yadav, Santosh Kumar, and Sabita Acharya. 2012. Dental Management Of The
Medically Compromised Patient Management Of The Medically Compromised
Dental Patient