To reduce any study variability, similar contralateral or counterpart teeth were removed. Atraumatic surgical extractions were carried out under local anesthesia [Figure 1]. The surgical site was randomly chosen for management either by a custom-cut chitosan dressing (study site) or a sterile cotton gauze (control site). Trimmed chitosan dressing material was prepared so as to fit loosely into the extraction sockets, at the height of crestal bone, wherever possible. After placement, finger pressure was applied over the chitosan dressing for 40–60s. Suturing was performed in the extraction wounds where hemostasis was not attained with sterile gauze piece, even after 15min. All the subjects were given amoxicillin 500mg/TID/5 days and Diclomol/TID/3 days. Patients were reviewed on the first, third, fifth, and seventh postoperative days and every week till 4 weeks [Figure 2]. The parameters assessed were timing of hemostasis, pain scores, and pus discharge. Healing was assessed based on sinus opening/pus discharge/wound infection, and dry socket.
Out of 40 subjects, 24 (60%) were males and 16 (40%) were females. The age was between 40 and 65 years (mean age 54 years). The mean time of hemostasis was 0.63±0.27min in study group, whereas for controls, it was 9.10±2.28min, difference being statistically significant (P = 0.001: [Table 1]).
The frequency distribution of postoperative pain showed significant variation (P = 0.001) on days one, five, and seven [Table 2].
In chitosan extraction sites, dry socket was not observed in any of the patients. Whereas four patients on day three and five on day four after extraction, experienced dry socket in pressure gauze dressings group, with an insignificant difference (P = 0.058; [Table 3]). In cases with dry socket, additional treatment was given by placing eugenol dressings.
In chitosan group extraction sites, pus discharge was not observed in any of the patients. Whereas four patients on days three and five after extraction had pus discharge in pressure dressing sites, with an insignificant difference (P = 0.058; [Table 4]). In cases where wound infection occurs, additional treatment was given in the form of antibiotics and debridement.
Correlation of OAT therapy with INR value revealed least INR value of 1.23±0.02 in subjects taking Ecosprin 75mg and highest value 2.23±0.35 in those taking Ecosprin 325mg + Clopilet 75mg [Table 5] and [[Graph 1].
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