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Oral Surgery > Common Post-Op Complications of Exodontia > Flashcards

Common Post-Op Complications of Exodontia Flashcards

1
Q

What happens in the 5 phases of wound healing

A

Phase 1: Haematoma and clot formation
Phase 2: Granulation tissue formation
Phase 3: Replacement of granulation tissue with CT
Phase 4: Replacement/maturation of CT into woven bone
Phase 5: Mature bone

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2
Q

What 2 things might cause severe pain after an extraction indicate

A
  • Dry socket

- Infection

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3
Q

What is the recommended pain killer course to be taken after an extraction

A
  1. 400mg of ibuprofen shortly after the extraction
  2. Then 500/1000mg of paracetamol in 3 hours
  3. Then 200/400mg of ibuprofen after 4 hours and so on
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4
Q

What is the max dose for paracetamol in a 24 hour period

A

4 grams

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5
Q

What is the max dose for ibuprofen in a 24 hour period

A

2400mg

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6
Q

When should paracetamol be avoided

A

In patients with severe liver disease

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7
Q

When should ibuprofen (and other NSAIDs) be avoided

A

In patients with:

  • Renal failure
  • Congenital or acquired bleeding disorders
  • Antiplatelet medications
  • Anticoagulant medications
  • Some asthmatics
  • GI disorders
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8
Q

When can primary haemorrhage occur

A

During the operation

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9
Q

What are some of the causes of primary haemorrhage

A
  • Soft tissue bleeding
  • Inflammation
  • Damage to blood vessels
  • Bony bleed
  • Granulomas
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10
Q

When does reactionary haemorrhage occur

A

A few hours after an operation

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11
Q

What can cause reactionary haemorrhage

A
  • Loss of the blood clot
  • Bleeding disorders
  • Antiplatelet/anticoagulant medications
  • Adrenaline wearing off, resulting in vasodilation
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12
Q

When does secondary haemorrhage occur

A

A few days after the extraction

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13
Q

What can cause secondary haemorrhage

A
  • Infection

- Bleeding disorder/anticoagulant treatment

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14
Q

What are the management methods for primary haemorrhage for patients without bleeding disorders

A
  1. Identify source and apply pressure, can use gauze soaked in LA with adrenaline
  2. Use haemostatic agents like oxidised cellulose or use diathermy if you can see the vessel
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15
Q

What are the management methods for primary haemorrhage for patients with a bleeding disorder

A
  • May need to use Tranexamic acid mouthwash and suturing
  • If the bleed is from the bone then identify the vessel and crush it with a blunt instrusment or apply bone wax (which is NON-resorbable)
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16
Q

What should be done if the haemorrhage is from the bone

A
  • Identify the vessel and crush it with a blunt instrument or apply bone wax (which is NON-resorbable)
17
Q

What are the management options for Reactionary haemorrhage

A
  • Advise patient to wet gauze and bite on it for 15mins, if it doesnt resolve after a few repetitions and there is continuous ooze/stream of blood, they should attend the practice
  • Repeat primary haemorrhage steps in practice after applying LA, removal of clots and cleaning of socket/wound
18
Q

What are the management steps for secondary haemorrhage

A
  • Identify cause

- May need to repeat primary haemorrhage steps plus antibiotics if infection is evident

19
Q

What should be mentioned to the patient about the bruising and swelling risk after an extraction

A
  • May take a few weeks to disappear and could change colours alot
  • Application of ice pack can help to reduce swelling but must be applied quick af after surgery or it’ll have no effect once swelling is established
20
Q

What is dry socket also known as

A

Alveolar Osteitis

21
Q

What is dry socket

A
  • Localised inflammation and infection of socket following extraction
22
Q

What are some of the factors that are associated with dry socket

A
  • Age of patient
  • Surgical trauma
  • History of smoking
  • Poor oral hygiene
  • Gender
  • Use of contraceptive pill
  • Concomitant periodontal disease
23
Q

What should be doe if the patient inhales the tooth/fragment

A
  • If ingested this is a less severe issue
  • Must ascertain if inhaled as it can cause significant morbidity
  • Send patient to A&E for an X-ray

Oral Surgery (11 decks)

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