Minor Oral Surgery Procedures in Patients Taking Warfarin : A 5-year retrospective study at Sultan Qaboos University Hospital, Sultanate of Oman

Abdulaziz A Bakathir

Abstract


Objectives: Minor oral surgery (MOS) procedures in warfarinised patients carry the risk of post-operative bleeding. The aim of this study was to conduct a retrospective analysis and to describe the profile of warfarinised patients who underwent MOS procedures at Sultan Qaboos University Hospital. Methods: A retrospective study of 124 warfarinised patients (41 men and 83 women), who had a pre-operative international normalised ratio (INR) of ≤ 3.5 and underwent different MOS procedures under local anaesthesia, without discontinuation of their warfarin therapy, was carried out over a 5-year period from January 2004 to December 2008. Results: Ninety (72.6%) patients had simple dental extractions, 26 (21%) surgical extractions, 6 (4.8%) soft tissue biopsies and 2 (1.6%) had apicectomies with cyst enucleations. Local measures were applied in all patients, which included the use of oxidizing regenerated cellulose haemostatic agent (Surgicel) and suturing. A total of eight patients (6.5%), five who had surgical extractions and three who had simple extractions, bled enough post-operatively to require a return to hospital. All cases of post-operative bleeding were managed conservatively by repacking the bleeding site with haemostatic agent and re-suturing without the need for hospital admission. Conclusion: Minor oral surgery procedures can be safely conducted in warfarinised patients without interruption of warfarin regimen when the pre-operative INR is ≤ 3.5 and appropriate local haemostatic measures are used. 



Keywords


Warfarin; Tooth extraction; Oral surgery; Postoperative haemorrhage; Complications.

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Sultan Qaboos University Medical Journal, College of Medicine and Health Sciences, Sultan Qaboos University, PO Box 35, Postal Code 123, Al-Khod, Muscat, Oman

ISSN (Print edition): 2075-051X ISSN (Internet edition): 2075-0528

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