Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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ACTIVE BLEEDING CARE DURING SURGICAL EXTRACTION OF MANDIBULAR THIRD MOLAR: REPORT OF TWO CASES

하악지치 발치 중 극심한 출혈 치험례

  • Kim, Jong-Bae (Department of Dentistry, School of Medicine, Keimyung University) ;
  • Yoo, Jae-Ha (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University(Wonju Christian Hospital)) ;
  • Moon, Seon-Jae (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University(Wonju Christian Hospital)) ;
  • Kim, Seung-Beom (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University(Wonju Christian Hospital))
  • 김종배 (계명대학교 의과대학 치과학교실) ;
  • 유재하 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원)) ;
  • 문선재 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원)) ;
  • 김승범 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원))
  • Published : 2001.12.30
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Abstract

The experienced surgeon can be surprised & challenged by the hazards of active bleeding during oral & maxillofacial surgical procedure, because of alterations in the surgical anatomy, bleeding disorders and surgical intervention of infected tissues. This is a report of two cases of active bleeding during surgical extraction of mandibular third molar, that had the pericoronitis, osteitis and adjacent neurovascular bundle in its apex. When the abrupt active bleeding was occurred during surgical extraction of mandibular third molar, pressure packing by hemostatie agent(bone wax) & wet gauze biting were applied into the extraction socket during 30 minutes. After 30 minutes, the wound was explored about the bleeding and active bleeding was then continued. In spite of repeated bleeding control method of the pressure dressing, the marked hemorrhage was generated continuously. Therefore, the author decised the bleeding as immediately uncontrollable hemorrhage and the pressure dressing was again applied for the more longer duration without wound closure. After 3 days, the pressure dressing was removed and iodoform gauze drainge was then established without the bleeding. The drain was changed as the interval of 3~5 days for prevention of infection & secondary hemorrhage and relatively good wound healing was then resulted in 6 weeks.

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