The Journal of Korea Assosiation for Disability and Oral Health (대한장애인치과학회지)

Korean Association for Disability and Oral Health (대한장애인치과학회)
권호 표지
DOI QR코드

DOI QR Code

BLEEDING CONTROL BY THE CIRCUMFERENTIAL SUTURE & DRAINAGE ON ACTIVE BLEEDING INCISION & DRAINAGE SITE OF TEMPORAL SPACE ABSCESS DUE TO ADVANCED ODONTOGENIC INFECTION IN A MULTIPLE MEDICALLY COMPROMISED DISABLED PATIENT : REPORT OF A CASE

다발성 전신질환 장애환자에서 진행성 치성감염에 의한 측두간극농양 절개 배농시 창상주위 봉합과 배농술에 의한 과도한 출혈조절 : 증례보고

  • Son, Jeong-Seog (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University(Wonju Severance Christian Hospital)) ;
  • Oh, Ji-Hyeon (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University(Wonju Severance Christian Hospital)) ;
  • Yoo, Jae-Ha (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University(Wonju Severance Christian Hospital))
  • 손정석 (연세대학교 치과대학 구강악안면외과학 교실(원주세브란스기독병원)) ;
  • 오지현 (연세대학교 치과대학 구강악안면외과학 교실(원주세브란스기독병원)) ;
  • 유재하 (연세대학교 치과대학 구강악안면외과학 교실(원주세브란스기독병원))
  • Received : 2013.05.20
  • Accepted : 2013.06.01
  • Published : 2013.06.28
Download PDF
⟨ Previous Next ⟩

Abstract

The four principles of treatment of odontogenic infection are as follows : (1) removal of the cause, (2) establishment of drainage, (3) institution of antibiotic therapy, and (4) provision of supportive care, including proper rest and nutrition. A separate incision is required to establish drainage, especially in the case of extensive fascial space infections. There are four principle causes for active bleeding in the immediate incision & drainage phase; (1) vascular wall alteration (infection, scurvy, chemicals), (2) disorder of platelet function, (3) thrombocytopenic purpuras, (4) disorders of coagulation (liver disease, anticoagulation drug). If the hemorrhage from incision & drainage site is aggressive, the site must be packed with proper wet gauze and wound closure & drainage dressing are applied. The specific causes of bleeding may be associated with hypoxia, changes in the pH of blood & chemical changes affecting vascular contractility and blood clotting. This is a case report of bleeding control by the circumferential suture & drainage on active bleeding incision & drainage site of temporal space abscess due to advanced odontogenic infection in a multiple medically compromised disabled patient.

Keywords

References

  1. Topazian RG and Goldburg MH : Management of infections of the oral and maxillofacial regions. Philadelphia, WB Saunders. 329-350, 1981.
  2. Kim GW, Kim KW, Kim SG et al : Oral & maxillofacial infection. Seoul, Jee Sung Publishing Co. 67-121, 2007.
  3. Kang HS, Moon HJ, Song KH, Kim SG : Contemporary oral & maxillofacial surgery. Seoul, Ko Moon Sa. 214-228, 2007.
  4. Korean Association of Oral & Maxillofacial surgeons: Textbook of oral & maxillofacial surgery, Second edition. Seoul, Medical & Dental Publishing Co. 139-172, 2005.
  5. Peterson LJ, Ellis lll E, Hupp JR, Tucker MR : Contemporary oral and maxillofacial surgery. Saint Louis, CV Mosby. 382-423, 1988.
  6. Little JW and Falace DA : Dental management of the medically compromised patient, Sixth edition. Saint Louis, CV Mosby. 332-364, 501-525, 2002.
  7. Sonis ST, Fazio RC and Fang L : Principles and practice of oral medicine, Second edition. Philadelphia, WB Saunders. 242-275, 1995.
  8. Conley JJ : Complications of head and neck surgery. Philadelphia, WB Saunders. 66-80. 1979.
  9. Falace DA : Emergency dental care. Baltimore, Williams and Wilkins. 209-226, 1995.
  10. Fonseca RJ and Walker RV : Oral and maxillofacial trauma, Vol I. Philadelphia, WB Saunders. 58-73. 1991.
  11. O'Ryan F, Diloreto D, Barber HD & Bruckner R : Orbital infections : clinical and radiographic diagnosis and surgical treatment. J Oral Maxillofac Surg 46(11):991-997, 1988. https://doi.org/10.1016/0278-2391(88)90336-9
  12. Peterson LJ : Contemporary management of deep infections of the neck. J Oral Maxillofac Surg 51:226-243, 1988.
  13. Bonoliel R, Leviner E and Katz J : Dental treatment for the patient on anticoagulant therapy. Oral Surg Oral Med Oral Pathol 62:149-155, 1986. https://doi.org/10.1016/0030-4220(86)90036-8
  14. Patton LL and Ship JA : Treatment of patients with bleeding disorders. Dent Clin Nor Am 38:465-482, 1994.
  15. Kelly MA : Common laboratory tests: their use in the detection and management of patients with bleeding disorders. Gen Dent 38:282-285, 1990.
  16. Schardt SD : Update on coagulopathies. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 90:559-563, 2000. https://doi.org/10.1067/moe.2000.110437