Dişhekimliğinde Cerrahi ve Cerrahi Olmayan İşlemlerde Kanama Kontrolü: Güncelleme

Kanama diyatezi bulunan hastalardaki kanama müdahalesi kanama diyatezinin ciddiyetine ve işlemin girişimsel derecesine bağlı olarak değişir. Bu hastalar değişen oranda risk taşırlar. Yapılacak işlemin kanama açısından risk oranı işlem yapılacak bölgenin ulaşılabilirliği ile doğru orantılıdır. Ulaşılabilirliği düşük bölgelerde sistemik olarak uygulanacak kanama kontrol yöntemleri daha önemlidir. Cerrahi sırasında yara iyileşmesini uzatacağı için lokal kanama kontrol yöntemleri agresif olarak uygulanmamalıdır. Dişhekimi orta ve ciddi hemorajik diyatezi bulunan hastalarda, hastanın doktoruyla konsültasyon yapmalıdır. Bu gibi hastalarda dental işleme başlamadan önce kanama kontrolü konusunda yeterli bilgi ve materyale sahip olmalıdır. Cerrahi sahadaki kanamanın durması, damarsal tıkanmanın sağlanması ve pıhtının bozulmasının engellenmesi için birçok işlem yapılabilir. Bu derlemede, topikal trombin, topikal fibrin yapıştırıcı, absorbe olabilen jelatin sünger, okside edilmiş selüloz, mikropöroz polisakkarit, fibrin yapıştırıcı, siyanoakrilat, traneksamik asit, aminokaproik asit, koterizasyon, basınç yöntemi, splint ve Ankaferd Blood Stopper değerlendirilmiştir

Anahtar Kelimeler:

Kanama müdahalesi, dişhekimliği, postoperatif kanama, koagülapatilerin müdahalesi

Management of Hemorrhage in Surgical and Non-Surgical Dental Procedures

The management of patients with bleeding disorders depends on the severity of the condition and the invasiveness of the planned dental procedure. These patients have variable risks. The risk of the intervention will depend on the access ibility of the surgical site for local control of hemostasis. Systemic prevention is more important for limited access to the bleeding sites. Local hemostatic techniques must not be used too aggressively during surgery as the resulting tissue damage can prolong healing time. Clinician has to make consultation on mild and severe hemorrhagic disordered patient with patient’s physician. Before managing dental surgery for these patients clinician has to have sufficient knowledge and material for controlling the hemorrhage. Various adjuncts to hemostasis can be employed at the surgical site to enhance hemostasis, aid in vascular closure and prevent clot breakdown. Topical thrombin, topical fibrin glue, absorbable gel atin sponge, oxidized cellulose, microporous polysaccharide hemispheres, fibrin sealant, n-butylcyanoacrylate, tranexamic acid, aminocaproic acid, cauterization, suturing, pressure, splint, Ankaferd Blood Stopper is the adjuncts that are evaluated in this review

Keywords:

Bleeding management, dentistry, postoperative bleeding, coagulopathies management,

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