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Local Fibrinolysis in the Oral Cavity
Author(s) -
Björlin G
Publication year - 1984
Publication title -
scandinavian journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0036-553X
DOI - 10.1111/j.1600-0609.1984.tb02593.x
Subject(s) - tranexamic acid , fibrinolysis , medicine , urokinase , plasmin , complication , oral administration , antifibrinolytic , surgery , oral mucosa , mucous membrane , gastroenterology , pathology , chemistry , biochemistry , enzyme , blood loss
In vitro tissue culture has shown that plasminogen activators are released both from normal and from pathological mucous membrane in the oral cavity. Immunological study (Ljungnér et al 1983) has shown that the plasminogen activators in the mucosa of the mouth are not urokinase in character. Increased local fibrinolytic activity, causing post‐operative bleeding, is a serious complication in patients with hemophilia or other bleeding disorders. The occurrence of pathologically increased local fibrinolytic activity can be prevented and the risk of post‐operative bleeding reduced by the administration of epsilon‐amino‐caproic acid (EACA) or tranexamic acid (AMCA). In 72 hemophilia patients, from whom 191 teeth were extracted, satisfactory results were achieved with but a simple dose of factor VIII and IX per patient in combination with the administration of tranexamic acid. In connection with oral surgery in a number of paitents with mild hemophilia A or mild von Willebrand's disease, the synthetic vasopressin derivative DDAVP has been used instead of factor concentrate. In connection with tranexamic acid, it enabled teeth to be extracted without any post‐operative bleeding complications.