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Abstract This study was done to evaluate Collaplug® (bovine collagen) as a local haemostatic material following extraction in patients under oral anticoagulant therapy according to their medical condition .The study consisted of 40 patients all were under oral anticoagulant therapy each patient was completely supervised by his physician, with the age ranged from 30 to 60 years, their INR < 3.The patients were divided into two equal groups; the control group and the study group. 1. The study group The patients were evaluated medically and dentally, also Their physician did not stop their routine regime of oral anticoagulant therapy, We used Collaplug® as a local haemostatic following dental extraction, the local hemostatic material was inserted inside the socket and sutures was done to keep the material in its place, adequate pressure packing and strictly post operative instructions, close follow up for the first 24 hours after extraction. 2. The control group The patients were evaluated medically and dentally. They were instructed by their physicians to continue their oral anticoagulants drug with close monitoring of the INR prior to extraction, INR < 3 which is safe range for minor oral surgical procedures for those medically compromised patients. After extraction suturing of the socket was done with adequate pressure packing and strictly post operative instructions to stop bleeding, close follow up for the first 24 hours after extraction. This study revealed the following results In the study group; bleeding was managed and coagulation achieved within 2 to 5 minutes after the application of Collaplug® within the extraction sockets and suturing using black silk 4-0, within the first 6 hours ,all patients showed no bleeding grade 0(G0) according to the WHO scale. 68 In the control group; bleeding was managed with difficulty within 15to 120 minutes, by pressure packs and suturing using atraumatic round needle. (black silk 4-0),and some cases to control the bleeding needed management for approximately first 6 hours after extraction and 7 cases has been managed by local application of gauze soacked in tranexamic acid in order to stop postoperative bleeding. During the 7 days of post operative follow up till suture removal, it was evident that the use of Collaplug® helped in the process of local hemostasis, pain reduction and improvement wound healing. The results were compared in both groups, local hemostasis and healing both were better and seemed to be faster with the use of Collaplug® than in the control cases. The post extraction complications including; postoperative bleeding, pain, infection, and or delayed healing were evaluated and there were nearly no postoperative complains through the use of the local hemostatic material Collaplug®. |