Abstract
National-wide survey concerning measures administered during minor oral surgery for patients managed with antithrombotic therapy was conducted. Questionnaire was sent to 583 institutes and replies were obtained from 239 (41%) institutes.
The survey revealed the following results:
1. Of the 239 institutes, 142 have fundamental concepts idea that antithrombotic drugs should not be interrupted or decreased during oral surgery such as tooth extraction.
2. In routine practice, 108 institutes declared that they interrupt or decrease the antithromboitic drugs for surgery depending on the necessity while 91 institutes replied that the antithrombotic drugs are continued in general and 43 institutes reported that they discontinue the drugs in principle. In case of interruption or decreasing of the drugs, many institutes considered the instruction or suggestion by medical doctors of the patients.
3. Postoperative bleeding was encountered at 120 of 239 institutes . The occurrence of bleeding complications revealed no relationship to the routine managements of antithrombotic drugs, which suggested that there might be many kinds of causes of postoperative hemorrhage.
4. In 23 institutes, they experienced severe complications, such as cerebral thrombosis, angina, myocardial infarction, etc, which were suspected to result from the interruption of antithrombotic drugs.
5. Suture, use of local hemostatic agents and accurate pressure on the wound were employed in most institutes for postoperative management for hemorrhage.
6. Many clinical examinations have been utilized for determining whether antithrombotic drugs should be continued or discontinued at each institute and the ideal standard examination and the standard value for making the decision could not be verified in this study.
7. Actual procedure of drug interruption varied among the institutes, although 3 or 4 days interruption of the anticoagulant agent and 7 days discontinuation of the antiplatelet agent were most pre dominantly employed. Therefore, a recommended procedure was not proposed in the study.
