Comparison of two hemostatic agents in patients receiving anticoagulants without altering medication dosage

Background: Patients under anticoagulant therapy who need tooth extraction, face the problem of intraoperative and postoperative bleeding which may be difficult to control. Some surgeons use the option of stopping the medication or altering its dose for three to four days preoperatively to obtain adequate hemostasis; however, this may carry the risk of thromboembolism.
Objective: This study aims to compare the effect of Gelatamp and Chitosan in control of post-extraction bleeding and prevention of complications as dry socket in patients receiving anticoagulant therapy without altering the medication dose.
Materials and Methods: Patients were divided into 2 equal groups each consisting of 20 patients. Patients of group 1 underwent extraction followed by insertion of Gelatamp (gelatine sponge with colloidal silver). Patients of group 2 underwent extraction followed by insertion of Chitosan as a local hemostatic agent. All patients were examined postoperatively for bleeding after 5 minutes, 30 minutes, 2 hours and after 24 hours.
Results: Comparing the 2 groups in the different follow-up periods with regards to postoperative bleeding, a statistically significant difference was found between the Gelatamp and Chitosan groups at 5 minutes, 30 minutes and 2 hours post-extraction in favor of Gelatatmp, while the 2 groups showed a non-significant difference at 24 hours after extraction. At the time of suture removal, proper wound healing was found in patients of both groups with no signs of dry socket, inflammation or infection.
Conclusion: Both Gelatamp and Chitosan have provided adequate control of bleeding in patients receiving anticoagulants without altering drug dosage, with Gelatamp showing superior hemostatic effect in the immediate post-extraction period.