Comparative evaluation of surgicel and gelfoam in controlling post-extraction bleeding in patients on anticoagulant therapy: a clinical study.

BACKGROUND

Bleeding after tooth extraction is a significant challenge, particularly in patients taking anticoagulants such as aspirin and warfarin, as the use of these medications increases the risk of prolonged bleeding. This study aimed to evaluate the effectiveness of the hemostatic agents, Surgicel and Gelfoam, in controlling bleeding and improving healing after extraction in this patient group.

METHODS

A clinical study was conducted on 40 patients, divided into two groups based on the type of anticoagulant used (aspirin or warfarin). Each patient received treatment with different hemostatic dressings: Gelfoam was applied to one side and Surgicel to the other. Bleeding was assessed using the VIBe scale, and the rate of gingival healing was measured using the Gingival Healing Index (GHI) on days three (D3) and seven (D7). Pain was also assessed using the Visual Analogue Scale (VAS), and late bleeding rates were analyzed 24 h after extraction.

RESULTS

The results showed that Surgicel was more effective than Gelfoam in achieving hemostasis and reducing delayed bleeding (p < 0.05). Patients using Surgicel also reported faster improvement in tissue healing compared to patients using Gelfoam, particularly on day 7 after extraction. Additionally, pain scores were significantly lower in patients treated with Surgicel compared to Gelfoam, reflecting its role in improving patient comfort and accelerating healing.

CONCLUSIONS

This study supports the use of Surgicel as a more effective option for controlling bleeding and promoting tissue healing in patients taking anticoagulants, reducing the need for treatment adjustments that may increase the risk of thrombosis. The study recommends further studies to evaluate the long-term benefits of using different hemostatic agents in this patient population.

TRIAL REGISTRATION

The trial was retrospectively registered at the ISRCTN registry (ISRCTN19155058) on 29 May 2025.