항응고제 투여중인 다발성 장애환자에서 골수이식전 발치창 출혈부의 전색과 배농술을 통한 출혈과 감염의 조절 : 증례보고
BLEEDING & INFECTION CONTROL BY THE PACKING AND DRAINAGE ON BLEEDING EXTRACTION SOCKET BEFORE BONE MARROW TRANSPLANTATION IN A MULTIPLE DISABLED PATIENT WITH ANTICOAGULATION DRUG : REPORT OF A CASE
유재하, 손정석, 김종배,
소속 상세정보
유재하 ( Yoo Jae-Ha ) - 연세대학교 치과대학 구강악안면외과학교실
손정석 ( Son Jeong-Seog ) - 연세대학교 치과대학 구강악안면외과학교실
김종배 ( Kim Jong-Bae ) - 계명대학교 의과대학 동산의료원 치과학교실
KMID : 1144020120080010015
Abstract
Extraction of all nonrestorable teeth prior to bone marrow transplantation is the major dental management of the patient being prepared for the transplantation. But, there are four principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (3) Thrombocytopenic purpuras (4) Disorders of coagulation (liver disease, anticoagulation drug-heparin, coumarin, aspirin, plavix) If the hemorrhage from postextraction wound is unusually aggressive, the socket must be packed with local hemostatic agent and wound closure & pressure dressing are applied. But, in dental alveoli, local hemostatic agent (gelfoam, surgcel etc) may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding and infection control by suture, pressure packing and iodoform gauze drainage on infected active bleeding extraction socket under sedation and local anesthesia in a 57-years-old multiple disabled patient with anticoagulation drug.
키워드
Bleeding extraction socket; Pressure packing; Iodoform gauze drainage; Anticoagulation drug; Bone marrow transplantation
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