Post-extraction bleeding

Description:

The odontectomy is followed by bleeding most of which often stops in a few minutes with formation of a blood clot. However in certain cases it independently does not stop and proceeds a long time – primary bleeding. Sometimes bleeding develops after operation after a while (in several hours and even days – secondary bleeding. Long bleedings are most often caused by the local reasons, is more rare – the general.

Symptoms of Post-extraction bleeding:

As a result of long bleeding and blood loss the general condition of the patient worsens, appears weakness, dizzinesses, pallor of integuments, a Crocq's disease. Pulse becomes frequent, can arterial pressure will decrease. The hole of the extracted tooth, an alveolar shoot and the next teeth are covered with a blood clot from under which blood follows

Reasons of Post-extraction bleeding:

Local reasons of alveolar bleedings: damage (a gap, crush) of vessels of soft tissues and a bone at traumatic carrying out operation; otly walls of an alveolus or interroot partition; existence of an intra bone vascular tumor; at acute inflammatory process (peristatic hyperemia), in the second phase of action of vazokostriktor (вазопарез), at purulent fusion of a blood clot and blood clots in vessels at an alveolitis.
The general reasons of long post-extraction bleedings are caused by disturbance of process of a fibrillation or disturbance of vascular system. Hemorrhagic diathesis concerns to them: hemophilia, a Werlhof's disease (Verlgof's disease), a hemorrhagic vasculitis, a hemorrhagic angiomatosis (Rendyu-Opeler's disease), an angiogemophilia (Villebran's disease), the S-avitaminosis, diseases which are followed by hemorrhagic symptoms: acute leukosis, infectious hepatitis, septic endocarditis, sypny and typhoid, scarlet fever, etc.; at the patients receiving anticoagulants at the patients having a hypertension.

Treatment of Post-extraction bleeding:

By means of surgical instruments delete a blood clot from a hole, dry up it and the adjacent site of an alveolar shoot, wounds examine and find out the bleeding reason, its character and localization.
Bleeding from the injured mucous membrane is stopped by suture on a wound, on a wound, by bandagings of vessels or underrunning of fabrics, bleeding from small vessels it is possible to stop electrothermic coagulation them.
At damage of a bone vessel it is squeezed nippers or other surgical instrument. After a bleeding stop the postoperative wound should be sewn up.

From depth of a hole make its tamponade for a bleeding stop various means. The easiest and available way of a hemostasis is the tamponade a yodoformny gauze which is taken from a hole not earlier than 5-6 days, after the beginning of a granulation of walls of a hole.
For a tamponade of a hole it is possible to use a styptic gauze of Oksitselodin, and also the gauze impregnated with solution of thrombin, Haemophobinum, an epsilon aminocapronic acid, an ampfer, drug a kaprofer.

The good haemo static effect gives introduction to a hole of resorptional biological haemo static drugs: absorbable gelatin sponge, fibrinny film, cotton wool, foam, fibrinny glue, biological antiseptic tampon (BAT), gelatinous or collagenic sponge, etc.