The hemostatic sponge is an important tool in the home and travel first aid kit and the best assistant to the surgeon. When used, it is possible to quickly stop bleeding. Today, hemostatic sponges come in a huge variety. They can be easily selected in size depending on the conditions of use.
Features of wound healing after tooth extraction
Before moving directly to hemostatic sponges, what they consist of and how to use them, you need to understand how the wound heals after removal and what can go wrong here. More on this later.
Why is there bleeding after removal?
Bleeding is a natural reaction to surgery. After all, when a tooth is removed, the smallest capillaries that penetrate the gums and ligamentous apparatus - the periodontium, which attaches the roots to the bone socket - are torn. And with difficult removal, the bleeding may be even stronger, because... The dentist makes incisions in the gums and drills into the jaw bone - the tissue is more damaged.
Bleeding is a natural reaction to surgery
Read on the topic: How long can a tooth hurt after extraction - normal and pathological.
How long does bleeding last normally?
Normally, the blood stops within 15-20 minutes (less often, within 45 minutes) and a blood clot forms in the socket. It seals the hole like a cork, preventing germs from penetrating inside. If the patient has problems that affect blood clotting, then the bleeding time is prolonged, and a clot may not form at all. And this is already fraught with inflammation of the bone socket (the pathology is called “alveolitis”). Therefore, according to indications, the dentist applies a hemostatic drug to the area of the extracted tooth.
On a note! Bleeding may appear again for a short time (and there will be quite a bit of blood) after the anesthetic wears off - if it contained adrenaline. This substance narrows the blood vessels in the intervention area, and as they expand normally, slight bleeding occurs. It goes away quickly.
Why does the bleeding not stop for a long time?
As a rule, after tooth extraction, the dentist says that you should not eat or drink for 2 hours. But few people say that you should not rinse your mouth or suck drinks out of a straw. In the first days, only oral baths are allowed, and it is better to drink in the usual way. Also, do not touch the wound with a brush. It is better to chew food on the healthy “side” of the jaw. Otherwise, there is a risk of moving or “pulling” the clot out of the hole - which will provoke new bleeding or even inflammation, which will result in long-term treatment.
The following groups of patients are also at risk:
- who has not formed a blood clot,
- with blood diseases,
- who takes blood clotting medications,
- having high blood pressure,
- women during menstruation or menopause,
- exposing themselves to physical activity immediately after removal and during the recovery process,
- if there was already inflammation at the extraction site (for example, pericoronitis above a wisdom tooth),
- during complex operations: when several teeth were removed at the same time, or manipulations were performed with increased tissue trauma.
Bleeding may occur during physical exertion after removal.
When you need urgent help
If the bleeding is profuse and does not stop for a long time, if after normalization of the condition the blood begins to ooze heavily again, this is a reason to consult a dentist. In a situation where the patient, in the presence of continuous bleeding, feels weakness, apathy, if the temperature has risen sharply (above 39 degrees Celsius), it is better to call an ambulance or go to the hospital on your own.
What is a hemostatic sponge
Now let's move on to why a hemostatic sponge is placed in the hole left after tooth extraction? Let's first understand the terminology. “Hemo” means “blood” and “stasis” means stopping. Those. a hemostatic sponge is needed to stop bleeding. In simple terms, this is a kind of replacement for a blood clot. The hemostatic sponge in the tooth socket not only seals the open cavity, but also has a hemostatic effect. Firstly, it puts pressure on small vessels, stopping bleeding. Secondly, it absorbs excess blood, increasing several times. The bleeding stops within 2-3 minutes.
On a note! By the way, local hemostatic agents are used not only in dentistry, but also in other areas of medicine - for example, hemostatic bandages successfully replace tourniquets that are applied for bleeding.
Recommendations
The collagen sponge should be removed from the packaging immediately before use. It is important to follow the rules of asepsis to prevent accidental infection in the wound. The hemostatic agent is carefully applied to the bleeding area and held for a couple of minutes. Deep wounds are tightly packed and then bandaged.
After the collagen sponge is saturated with blood, it will slightly increase in size. This will ensure that it adheres tightly to the damaged bleeding area. In cases where it is necessary to close damaged areas of parenchymal organs, a sponge of a suitable size is placed in the existing cavities. To stop bleeding, it is allowed to form several layers from it. After this, it is fixed using a U-shaped seam.
You can now buy a collagen hemostatic tube in pharmacies at an affordable price. It is presented by manufacturers in a wide range. You can also pick up the product in specialized online stores. Now you can use the booking service or order delivery of the product to the specified address.
Before using a collagen-based hemostatic sponge, you should carefully read the manufacturer's instructions. The product should be stored in a dry place where the temperature is maintained in the range of 10°C - 30°C. With high humidity, the sponge quickly becomes unusable. The shelf life of the product, subject to the required conditions, is 5 years.
Appearance and release form
The hemostatic sponge looks like a cube or plate, which looks like a small sponge or a piece of yellow or white foam rubber. Although in fact it consists mainly of natural collagen with various medicinal additives. The plate is quite soft and easy to cut, which allows the dentist to cut the desired size according to the shape of the hole.
The plate is quite soft and easy to cut
Manufacturers produce both small (1x1 centimeter) and large sponges (10x10 cm). The plates are tightly sealed in transparent bags, and the cubes are sealed in dark, opaque bottles. Hemostatic powders and gels are also produced. Absolutely all collagen hemostatics dissolve on their own in the wound over time.
Types of hemostatic sponges
According to the manufacturing method, hemostatic sponges for teeth are of the following types:
- from donor blood plasma - amben,
- from bones/tendons/blood of cattle - collagen and gelatin.
You need to understand that a hemostatic agent not only stops bleeding (due to aminocaproic acid, for example) and stimulates the formation of a blood clot, but also has an antiseptic effect. It can also accelerate regeneration and relieve inflammation. It all depends on the active components that make up the hemostatic sponge. The drug can be impregnated with the following substances:
- antiseptics: chlorhexidine, furatsilin, silver suspension, boric acid, iodoform,
- local anesthetics: for example, lidocaine,
- preparations for bone regeneration: calcium phosphate,
- antibiotics: metronidazole, chloramphenicol, neomycin, gentamicin, etc.,
- natural substances: propolis, eugenol, etc.
Hemostatic sponges for teeth come in different types
What is she?
So, a hemostatic sponge is an effective hemostatic agent, widely used in various medical fields, in particular, by dentists when removing teeth. The sponge has pronounced antiseptic and sorbing properties, and therefore not only stops bleeding, but also protects the wound from bacteria. In addition, thanks to the described remedy, damaged sockets heal faster.
Main types of hemostatic sponges
So, the described remedy is intended not only to stop bleeding, but also to prevent the occurrence of inflammatory processes if a complex surgical intervention was performed (for example, a wisdom tooth was removed). In standard cases of extraction, bleeding is stopped with the help of a collagen sponge that stops the bleeding.
After surgery, if there is a risk of inflammation in the tooth socket, dentists often recommend using “Alvostaz” - this is a special alveolar compress made in the form of a sponge. "Alvostaz" has an antiseptic and hemostatic effect, in addition, the drug is often used for the prevention/therapy of alveolitis.
About release forms
So, what is a hemostatic sponge? Essentially, it is a yellowish pressed powder that has a faint aroma of acetic acid. These sponges are sold in the form of small rectangular elastic plates (their sizes can be 5x5 cm and 9x9 cm) with a porous dry structure. During production, sponges are placed in PET bags, which are tightly closed, and then placed individually in cardboard packaging.
These sponges - just like regular sponges - perfectly absorb liquid, swelling at the same time. Sponges do not dissolve in cold water, as well as in substances of organic origin, but can partially dissolve in water whose temperature is more than 75 degrees. To make pressed plates, a collagen solution is used - it is obtained from the tendons/skin of cattle. There are also additional components - boric acid and nitrofural.
The above-mentioned “Alvostaz” is considered one of the most effective remedies. The product is sold in the form of small (dimensions - 1x1 cm) hemostatic sponges soaked in a special solution, packaged in plastic jars of 30 pieces. "Alvostaz" is produced in three versions; it contains propolis, eugenol, tricalcium phosphate, iodoform, lidocaine and thymol.
Effect of hemostatic sponges
The product described in the article is used locally (it is used to pack wounds) and has a wide spectrum of action, namely:
- stops bleeding;
- accelerates wound healing;
- protects the hole from bacterial infection;
- prevents swelling of gum tissue;
- stops the focus of the inflammatory process;
- eliminates painful sensations.
Note! The hemostatic sponge is effective for several hours after tooth extraction. After a certain time (indicated by the manufacturer), the sponge placed in the hole dissolves completely.
Manufacturers of hemostatic sponges
Popular manufacturers of hemostatic agents used by dentists in our country are domestic companies. Let's consider them further:
- Alvostaz compress from Omega-Dent: available in the form of cubes, flagella, powders and solutions. The compresses are numbered - “1” with iodoform, “2” with metronidazole and chlorhexidine, “3” with neomycin and chloramphenicol,
- "Gemasept" with gentamicin from the Russian Research Institute of Hematology and Transfusiology of the Federal Medical and Biological Agency",
- “Collagen hemostatic sponge” with silver and boric acid from “Zelenaya Dubrava”,
- “Hemostatic sponge” with furatsilin and boric acid from “Belkozin”.
Biological dressing Digestol
Biological dressing "Digestol" - Self-absorbing collagen wound coverings with a cleansing and antibacterial effect, are highly porous white or cream-colored plates with a specific odor, made from a mixture of natural collagen biopolymer and trypsin-like enzymes digestase and collagenase (from the hepatopancreas of the Kamchatka crab). Ingredients: collagen at least 80%, digestase enzyme (collagenase) at least 1%, purified water Area of application: Complex treatment of purulent wounds, trophic ulcers, treatment of infectious and inflammatory diseases of the oral cavity, complications of diabetic foot syndrome. It has a rapid hemostatic effect by stimulating platelet aggregation and an antimicrobial effect by destroying the walls of bacteria. For the complex treatment of purulent wounds, burns, trophic ulcers, bedsores, gunshot wounds, treatment of infectious and inflammatory diseases of the oral cavity, complications of the “diabetic foot” syndrome in surgery, tamponing of sockets in dentistry. Has a cleansing and antibacterial effect. It has a rapid hemostatic effect by stimulating platelet aggregation and an antimicrobial effect by destroying the walls of bacteria. Dimensions 100x100x5 No. 1, 50x50x5 No. 1, 10x10x5 No. 10. pH of the aqueous extract: 5.0-7.5 Sterile, single use Sterilization: radiation Guaranteed shelf life of the plates from the date of sterilization: 3 years. Manufacturer: ZAO “Zelenaya Dubrava” , Russia Price: on request
Indications for use
A hemostatic sponge can be useful after tooth extraction, especially wisdom teeth. Because the “eights” often do not erupt completely, and the dentist has to perform a mini-operation to get to them and remove them along with the roots. When a tooth is removed, a hemostatic agent is placed 3-4 months before implantation to completely eliminate the possibility of complications and problems with the formation of new bone in the socket.
Also, hemostatic sponges or powders are used during operations on the gums1 - plastic surgery, curettage of gum pockets (removal of deep “deposits” of tartar), and when cutting off dead areas of the jaw bone due to osteomyelitis. In the latter case, bone blocks and materials for regeneration of bone substance are additionally planted. In general, the doctor always assesses the patient’s condition in advance - asks about diseases and other conditions, and about the medications taken. If there is a risk of bleeding or poor regeneration, then rest assured, a hemostatic sponge will definitely be placed in the hole.
These sponges are used for bone augmentation
It is important to know! A few days after tooth extraction, it may be necessary to apply a hemostatic sponge if the dentist sees a tendency to worsen. For example, a clot has fallen out or the gums/bone have become inflamed.
How to use the drug correctly
How to use the sponge? The hemostatic sponge is placed into the socket of the extracted tooth only by the dentist. Home use is not recommended due to the risk of infection deep into the tissues. The application procedure is given step by step below:
- tooth extraction or treatment of the hole a few days after removal: in the latter case, purulent masses are removed, irrigation is carried out with an antiseptic,
- a piece of the hemostatic plate is cut off with sterile scissors or a hemostatic cube is taken with tweezers,
- the drug is placed in the hole and pressed with a flat instrument: if the hemostatic agent is pre-saturated with thrombin, the hemostatic effect is enhanced,
- if necessary, an additional piece of hemostatic is applied,
- if necessary, a small tampon is placed on top of the hole (it will be removed the next day),
- suturing the gums - a seam in the shape of the letter “P”: also, if necessary, in most cases you can do without stitches.
A piece of the hemostatic plate is cut with sterile scissors.
Application
Hemostatic agents are used locally to pack the wound when necessary:
- Stop parenchymal and capillary bleeding;
- Close the gallbladder bed after surgery;
- Stop bleeding in the bone marrow canals;
- With tamponade of the sinuses of the dura mater of the brain;
- To strengthen the suture of the intestinal anastomosis;
- To strengthen the suture of the vascular anastomosis;
- Get rid of alveolar bleeding in the tooth extraction cavity.
Before use, the package should be opened with sterile scissors and gloves. Then, remove the gelatin plastic and apply it to the bleeding site, pressing lightly for 1-2 minutes. It can also be used after soaking it in saline or antibiotic.
Is it necessary to remove the hemostatic agent?
Patients often wonder what to do with a hemostatic sponge after it has been placed in the socket of an extracted tooth? How long should I keep it on, and will it dissolve on its own? The rules of conduct are as follows: carefully but thoroughly observe oral hygiene, and also take medications prescribed by the dentist. There is no need to specially remove the hemostatic agent - after all, it consists of components that will completely dissolve during wound healing. And instead of a hemostatic agent, its own tissues form in the hole.
“When my wisdom tooth was removed, they stuffed it into the wound like a piece of foam rubber. I then saw the houses through the seams. I was also surprised - what is it? And at the next appointment, my dentist told me that this is a special sponge that absorbs blood and protects against infection. And when it resolved, I didn’t even notice)) It probably completely disappeared in a couple of weeks.”
Ekaterina R., review from irecommend.com
Contraindications and side effects
The only contraindication to the use of a hemostatic sponge after tooth extraction is an individual allergy to any of the components of the drug. In particular, for antibiotics that are used to impregnate the hemostatic agent. Therefore, be sure to tell your dentist if you are allergic and to what medications. Hemostatic agents should also be used with extreme caution in children.
There are no side effects, because There are no toxic substances or components that affect perception in hemostatics. But if itching, inflammation, or swelling appears, feel free to contact your dentist. These manifestations can be caused either by a newly manifested allergy or by incipient complications - if, for example, the treatment was carried out poorly or the patient did not follow the doctor’s instructions.
1Skulean A. Periodontal regeneration, 2012.
Contraindications
The main contraindication to the use of collagen sponges to stop bleeding is hypersensitivity to any components used in their manufacture. In particular, this is intolerance to nitrofuran drugs. With increased sensitivity to them, severe allergic skin reactions are observed, accompanied by severe itching.
Collagen sponges should not be used to stop arterial bleeding. In this case, a tourniquet must be applied and the person must be urgently transported to a medical facility to provide qualified surgical care.
Contraindications to the use of collagen-based hemostatic sponges are skin lesions caused by pyogenic bacteria. In this case, the wound must be periodically treated with antiseptic agents to remove its purulent contents.
