Oral surgery in patients with antiphospholipid syndrome

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  • Okuyama Kohei
    Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences Division of Oral and Maxillofacial Surgery, Department of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
  • Naruse Tomofumi
    Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences
  • Yutori Hirokazu
    Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences
  • Yanamoto Souichi
    Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences
  • Umeda Masahiro
    Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences

Abstract

<p>Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by recurrent thrombosis, other associated autoimmune disease, and/or obstetrical morbidity along with persistent production of antiphospholipid antibodies. Because of the nature of this systemic disease, most patients are medicated with antithrombotic agents and abundant glucocorticoids. This study reports a cohort of 16 patients with APS, who underwent oral surgery between 2010 and 2017 at the Nagasaki University Hospital. Because oral antithrombotic therapy was continued in the perioperative period, all wounds were strictly closed by suturing to prevent postoperative bleeding. Perioperative laboratory dates and medications were assessed. All patients achieved local postoperative hemostasis and did not exhibit systemic complications. Moreover, there were no postoperative systemic and/or local infections. Oral surgeons should suture oral wounds and ensure local hemostasis to prevent postoperative bleeding. Because patients with APS are likely to develop thrombosis despite continued administration of antithrombotic medications, strict perioperative examination of blood coagulation is needed. Furthermore, it is important to consider the damage and stress caused due to oral surgery. Moreover, when necessary, glucocorticoid therapy should be carefully administered, in accordance with the degree of invasion and judgment of the attending physician.</p>

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