[Safe minor surgery in patients taking anticoagulants]

Area of Science:

• Biomedical Engineering
• Hematology
• Surgical Innovation

Context:

• Oral anticoagulant therapy (OAT) with acenocoumarin poses challenges for minor surgical procedures due to bleeding risks.
• Traditional management often requires discontinuation of OAT, increasing thrombotic risks.
• Alternative hemostatic methods are needed to facilitate safe and effective procedures in OAT patients.

Purpose:

• To evaluate the efficacy and safety of a topical hemostatic agent (Tissucol) in patients undergoing minor surgical procedures while on oral anticoagulant treatment.
• To assess the incidence of bleeding complications and the need for additional hemostatic interventions.
• To determine the impact on procedure duration and patient outcomes.

Summary:

• A commercial fibrinogen, thrombin, and factor XIII concentrate (Tissucol) was used in 127 patients on acenocoumarin undergoing 183 minor procedures (exodontia, periodontal, biopsies).
• Mild hemorrhage occurred in 21 instances, but no patients required systemic coagulation factors or experienced prolonged procedure times.
• The hemostatic agent facilitated outpatient procedures, minimizing patient discomfort and the need for hospital admission.

Impact:

• Demonstrates a safe and effective method for managing surgical procedures in patients on oral anticoagulation, reducing the need to interrupt therapy.
• Offers a less invasive and more comfortable patient experience, potentially consolidating multiple procedures into single sessions.
• Presents a cost-effective solution by avoiding hospital admissions and substitutive therapies, thereby reducing the overall economic burden.