Matched cohort study evaluating the hemostatic efficacy of fibrin sealant versus conventional approaches following dental surgery in patients with hemophilia

Int J Oral Maxillofac Surg. 2024 Nov;53(11):981-987. doi: 10.1016/j.ijom.2024.07.012. Epub 2024 Jul 26.

Abstract

Patients with hemophilia frequently require supplementary interventions, either invasive (suturing, gel foam, or cauterization) or non-invasive (fibrin sealant/glue), to attain hemostasis post dental procedures. This study aimed to compare the efficacy of fibrin sealant against traditional methods for achieving hemostasis post dental surgery. The medical records of patients with factor VIII or IX deficiency, or von Willebrand disease, who underwent dental procedures in the Department of Dentistry, Seth GSMC and KEM Hospital, were evaluated for inclusion in this retrospective matched cohort study. Cohort-1 included those treated with a fibrin sealant (Tisseel Lyo) with/without traditional hemostatic measures post-procedure, while cohort-2 (controls) included those in whom no fibrin sealant was used. A total of 128 patients, 64 in each group, were evaluated. There was no statistically significant difference in demographics, disease-related variables, dental complaints, or preoperative treatment given between the groups. However, there was a significant reduction (P < 0.001) in the requirement for secondary procedures for hemostasis (suturing, gel foam application, and/or cauterization) and postoperative requirement for factor replacement (P = 0.003) in the fibrin glue group as compared to the controls. In this study, fibrin sealant demonstrated superior efficacy in mitigating the necessity for active hemostasis control.

Keywords: Fibrin tissue adhesive; Hemophilia A; Hemophilia B; Hemostatics; Von Willebrand disease.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Fibrin Tissue Adhesive* / therapeutic use
  • Hemophilia A* / complications
  • Hemostatics* / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Oral Surgical Procedures / methods
  • Postoperative Hemorrhage / prevention & control
  • Retrospective Studies
  • Treatment Outcome
  • von Willebrand Diseases / complications

Substances

  • Fibrin Tissue Adhesive
  • Hemostatics