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. 2010 Dec 29:26–455. doi: 10.1016/B978-0-443-07151-5.50005-6

Table 3.151.

Manifestations of thrombocytopenia and management in relation to oral surgery

Platelet count (× 109/L) Severity of thrombocytopenia Manifestations Management in relation to type of oral surgery
Dentoalveolar Major
100–150 Mild

  • Mild purpura sometimes

  • Slight increase in postoperative bleeding

  • No platelet transfusion

  • Local haemostatic measures*

  • Observe

  • Consider platelet transfusion

  • Local haemostatic measures*

  • Observe
50–100 Moderate Purpura, postoperative bleeding

  • Platelets may be needed

  • Local haemostatic measures*

  • Consider postoperative tranexamic acid mouthwash for 7 days

  • Platelets needed

  • Local haemostatic measures*

  • Postoperative tranexamic acid mouthwash for 7 days
30–50 Severe Purpura, postoperative bleeding, and even from venepuncture

  • Platelets needed

  • Local haemostatic measures*

  • Postoperative tranexamic acid mouthwash for 7 days

  • Platelets needed

  • Local haemostatic measures*

  • Avoid surgery where possible

  • Postoperative tranexamic acid mouthwash for 7 days
<30 Life-threatening Purpura, spontaneous bleeding

  • Platelets needed

  • Local haemostatic measures*

  • Avoid surgery where possible

  • Postoperative tranexamic acid mouthwash for 3 days

  • Platelets needed

  • Local haemostatic measures*

  • Avoid surgery where possible

  • Postoperative tranexamic acid mouthwash for 3 days
*

Local haemostatic measures = compressive packing, sutures, and microfibrillar collagen or oxidised cellulose.