Our Summary

This research paper is about a study that looked at how oral surgery impacts the body’s blood clotting process, specifically targeting fibrin, a protein that helps in clot formation. The study also evaluated the effects of a drug called tranexamic acid (TXA) on this process.

The study was conducted on patients who were undergoing orthognathic surgery, a procedure to correct conditions of the jaw and face related to structure, growth, sleep apnea, TMJ disorders, malocclusion problems owing to skeletal disharmonies, or other orthodontic problems. Some of these patients were given TXA, while others were given a placebo.

The research found that after surgery, the breakdown of fibrin, which is a crucial part of the clotting process, decreased. This effect was even more pronounced in patients who were given TXA. The surgery also changed the properties of the fibrin, pushing the body’s balance towards being more likely to form clots, a state known as being prothrombotic.

In simpler terms, the study found that this type of oral surgery makes the body more likely to form blood clots, and this effect is even stronger when the patient is given the drug tranexamic acid.

FAQs

  1. How does orthognathic surgery impact the body’s blood clotting process?
  2. What is the role of tranexamic acid (TXA) in the clotting process during orthognathic surgery?
  3. What is the meaning of the term “prothrombotic” in relation to the effects of orthognathic surgery and use of TXA?

Doctor’s Tip

A helpful tip a doctor might tell a patient about orthognathic surgery is to be aware of the increased risk of blood clot formation during and after the procedure. It is important to follow all post-operative care instructions, including any prescribed medications, to reduce this risk. Additionally, staying hydrated, moving around periodically, and wearing compression stockings as directed by your healthcare provider can help prevent blood clots. If you experience any symptoms of a blood clot, such as swelling, redness, warmth, or pain in your legs, chest pain, or difficulty breathing, seek medical attention immediately.

Suitable For

Therefore, patients who are recommended orthognathic surgery may have conditions that require correction of their jaw and facial structure, such as those mentioned above. These patients may also be at a higher risk for blood clotting issues, which is important for healthcare providers to consider when planning and performing the surgery. Additionally, patients who are given tranexamic acid as part of their treatment may experience stronger effects on their blood clotting process.

Timeline

Before orthognathic surgery:

  1. Patient meets with oral surgeon to discuss the procedure and any potential risks or complications.
  2. Pre-operative assessments and tests are conducted to ensure the patient is a suitable candidate for surgery.
  3. Patient may undergo orthodontic treatment to prepare the teeth and jaws for surgery.
  4. Patient receives instructions on how to prepare for surgery, including fasting before the procedure.
  5. Surgery date is scheduled and patient arranges for transportation and post-operative care.

After orthognathic surgery:

  1. Patient undergoes the surgical procedure under general anesthesia.
  2. Post-operative pain and swelling are managed with medications and cold compresses.
  3. Patient is placed on a liquid or soft food diet during the initial recovery period.
  4. Follow-up appointments are scheduled to monitor healing progress and remove any sutures.
  5. Patient may undergo physical therapy or speech therapy to regain normal function of the jaw and facial muscles.
  6. Orthodontic treatment continues to fine-tune the alignment of the teeth and jaws.
  7. Long-term follow-up appointments are scheduled to monitor the results of the surgery and address any concerns or complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about orthognathic surgery in light of this research include:

  1. How does orthognathic surgery specifically impact the body’s blood clotting process, and what are the potential risks associated with this aspect of the procedure?
  2. What is tranexamic acid (TXA) and why might it be used in conjunction with orthognathic surgery?
  3. What are the potential benefits and risks of using TXA during orthognathic surgery, especially in relation to the body’s blood clotting process?
  4. How will the use of TXA or other medications affect my recovery process and overall healing after orthognathic surgery?
  5. Are there any alternative options or precautions that can be taken to minimize the risk of blood clots during and after orthognathic surgery?
  6. How will the findings of this study be taken into consideration in my specific case and treatment plan?
  7. What measures will be put in place to monitor and manage any potential complications related to blood clotting during and after orthognathic surgery?
  8. How will the potential prothrombotic effects of orthognathic surgery be managed in the long term, especially in terms of preventing issues like deep vein thrombosis or pulmonary embolism?
  9. Are there any specific lifestyle changes or precautions I should take both before and after orthognathic surgery to reduce the risk of blood clots?
  10. What follow-up care and monitoring will be necessary to ensure my overall health and well-being in relation to the blood clotting effects of orthognathic surgery?

Reference

Authors: Sidelmann JJ, Gram JB, Godtfredsen ACM, Thorn JJ, Ingerslev J, Pinholt EM. Journal: J Oral Maxillofac Surg. 2020 Jul;78(7):1183-1189. doi: 10.1016/j.joms.2020.02.026. Epub 2020 Mar 3. PMID: 32224082