Minor oral surgery procedures in patients taking warfarin : a 5-year retrospective study at sultan Qaboos university hospital, sultanate of Oman

Abstract EN

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.