Post-surgical Instructions-Bleeding and Bruising

A certain amount of bleeding is to be expected following surgery. A small amount of bleeding, oozing, or redness in the saliva for 1 or 2 days is common. Remember that a lot of saliva and a little blood can look like a lot of bleeding. A blood clot should form in the extraction socket. This is a normal part of the healing process. It is important to remember, if the bleeding appears abnormal or if there are any concerns about bleeding, patients should contact the office or Dr. Maranon immediately for further instructions.

Some patients take blood thinners (Warfarin/Coumadin, Plavix, aspirin) to prevent or to treat conditions like strokes, blot clots, or heart attacks. It is very important for patients to discuss their use of any of these medications with Dr. Maranon, as it is sometimes necessary to adjust these medications before surgery. Dr. Maranon will need to discuss the surgical procedure with the patient’s prescribing physician and determine if adjustments in their medications is necessary.  Patients on these medications are more likely to have bruising and more importantly, excessive bleeding.

Immediately after surgery, it is important to bite with continuous firm pressure on moistened gauze, folded into a 2 inch square, and placed over the surgical site for about 2 hours. The gauze can be changed every 30 to 45 minutes thereafter. Prolonged use of the gauze or changing the gauze too frequently can cause bleeding to continue. To minimize bleeding, it is helpful to sit upright or elevate the head. Patients may want to cover their pillowcase in case they have bleeding while they are sleeping.

If there seems to be excessive bleeding, this may be controlled by gently rinsing or wiping out blood clots and then placing a fresh gauze pad over the site and biting firmly for 30 minutes. This can be repeated if necessary. If bleeding continues, this may be controlled by biting firmly on a moistened Lipton or black tea bag for 30 to 45 minutes. The tannic acid in the tea bag helps to stop bleeding. If there are any questions about bleeding, patients should contact the office or Dr. Maranon.

Exercise or strenuous activities should be avoided for 3 to 5 days after surgery as this can increase bleeding. It is also important to avoid vigorous rinsing, spitting out, or using straws to drink during the first 24 hours. Patients must not smoke after surgery. All of these activities can dislodge the blood clot. If the blood clot is dislodged, bleeding may continue or healing may be delayed.

Though infrequent, bruising or discoloration of the skin can occur 2 or 3 days following surgery. This condition is typically limited. These patients may notice that they develop black, blue, green, or yellow discoloration of the skin on the side of the surgery. These color changes may move down the neck or patients may have “black eyes”. Moist heat applied to the area may speed up the resolution of the bruising and discoloration.