A study to evaluate reduction in blood loss by topical application of tranexamic acid in burn wound surgery

Mohan, Amitabh; Vishwanath, G; Rajendran, Nagamahendran

doi:10.4103/jmms.jmms_25_20

Cited by 2 publications

(10 citation statements)

References 9 publications

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“…Five studies were included comprising two RCTs [ 14 , 15 ], one prospective observational cohort study [ 24 ] and two retrospective cohort studies [ 11 , 12 ]. Sample sizes of the single centre studies ranged from 30 participants [ 14 ] to 107 participants [ 11 ].…”

Section: Resultsmentioning

confidence: 99%

“…Mean %TBSA ranged from 26.72% [ 14 ] to 41.80% [ 15 ]. One study investigated the effect of tranexamic acid when administered topically [ 24 ]. The remaining four studies investigated the effect of tranexamic acid when administered intravenously.…”

Section: Resultsmentioning

confidence: 99%

“…Three cohort studies were included for the quality assessment with the ROBINS-I tool [ 11 , 12 , 24 ]. One study scored moderate risk of bias in outcome A(blood loss) [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

“…Three cohort studies were included for the quality assessment with the ROBINS-I tool [ 11 , 12 , 24 ]. One study scored moderate risk of bias in outcome A(blood loss) [ 24 ]. Two studies scored serious risk of bias for the other outcomes B(transfused pRBC’s) and C(Haemoglobin levels) [ 11 , 12 ].…”

Section: Resultsmentioning

confidence: 99%

“…Three cohort studies reported on the effectiveness of tranexamic acid in burn surgery. One study assessed blood loss and showed a statistically significant reduction of blood loss per unit excised area in the tranexamic acid group, 1.30 vs. 2.03 ml/cm 2 [ 24 ], when tranexamic acid was administered topically. The other two studies described statistically significant less pRBC’s transfusions in tranexamic acid groups [ 11 , 12 ].…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness of tranexamic acid in burn patients undergoing surgery – a systematic review and meta-analysis

Slob,

Gigengack,

van Baar

et al. 2024

BMC Anesthesiol

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Summary Background Reducing blood loss during excisional surgery in burn patients remains a challenge. Tranexamic acid during surgery can potentially reduce blood loss. The use of tranexamic acid during excisional surgery in burn patients has recently been described in a review and meta-analysis. However, quality assessment on studies included was not performed and this review did not apply independent reviewers. Quality assessment of studies investigating the effectiveness of tranexamic acid in burn patients is crucial before concusions can be drawn. Therefore, we conducted a systematic review and meta-analysis of the literature investigating the effectiveness of tranexamic acid in burn patients undergoing surgery. Methods A systematic review and meta-analysis of the literature was conducted. The study was pre-registered in PROSPERO database (CRD42023396183). Results Five studies including two randomised controlled trials (RCTs) with a total of 303 patients were included. Risk of bias of the included studies was moderate to high. Individual results of the studies were heterogeneous. In three studies of moderate quality the administration of tranexamic acid resulted in a reduction of blood loss per unit excised area, accounting as moderate level of evidence. In two low-quality studies and one moderate quality study the administration of tranexamic acid resulted in a reduction of transfused packed Red Blood Cells (pRBC’s), accounting for moderate level of evidence. Postoperative haemoglobin levels were higher after tranexamic acid administration in one study, accounting for insufficient evidence. Meta-analysis pooling overall blood loss from two separate RCTs failed to detect a statistically significant reduction. Substantial heterogeneity was observed. Conclusions Moderate level of evidence indicates that tranexamic acid reduces blood loss per unit of excised area and transfusion of packed Red Blood Cells. Results indicate that tranexamic acid can be beneficial in burn patients undergoing surgery. More high-quality research is needed to confirm these results. Future studies should focus on the dosing of tranexamic acid, the administration approaches, and even consider combining these approaches. Trial Registration PROSPERO: CRD42023396183

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Three cohort studies were included for the quality assessment with the ROBINS-I tool [ 11 , 12 , 24 ]. One study scored moderate risk of bias in outcome A(blood loss) [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Effectiveness of tranexamic acid in burn patients undergoing surgery – a systematic review and meta-analysis

Slob,

Gigengack,

van Baar

et al. 2024

BMC Anesthesiol

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Topical Tranexamic Acid on Donor Wounds in Burn Patients: A Randomized Placebo-controlled Trial

Colclough,

Almeland,

Brekke

et al. 2024

Plastic and Reconstructive Surgery - Global Open

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Background: Patients with major burn injuries are prone to massive blood loss owing to tangential excision of burn wounds and donor skin harvesting. In general, topical application of the antifibrinolytic drug tranexamic acid (TXA) to surgical wounds reduces bleeding; however, its effect on bleeding and re-epithelialization in superficial wounds of burns has not been explored. Methods: This study aimed to investigate the therapeutic potential of topical TXA in reducing blood loss and its effect on wound re-epithelialization in burn surgery. Split-thickness skin graft donor wounds in burn patients were paired and randomized to topical application of either TXA (25 mg/mL) or placebo. Endpoints were postoperative bleeding as measured by dressing weight gain per cm2 wound area, blood stain area per wound area, and visual evaluation of bleeding in the dressings. Healing time was recorded to analyze the effect on wound re-epithelialization. Results: There was no significant difference in bleeding or time to re-epithelialization between the TXA and placebo wounds. A post hoc subanalysis of wounds with dressing weight gain above the median, showed a significant difference in favor of TXA. However, use of tumescence may have influenced end points. No significant adverse events related to the study drugs were observed. Conclusions: This study demonstrates that topical application of TXA (25 mg/mL) to split-thickness skin graft donor wounds does not delay re-epithelialization. Although a reduction in bleeding is suggested, further studies are needed to determine the role of topical TXA in reducing bleeding in burn surgery.

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A study to evaluate reduction in blood loss by topical application of tranexamic acid in burn wound surgery

Cited by 2 publications

References 9 publications

Effectiveness of tranexamic acid in burn patients undergoing surgery – a systematic review and meta-analysis

Effectiveness of tranexamic acid in burn patients undergoing surgery – a systematic review and meta-analysis

Topical Tranexamic Acid on Donor Wounds in Burn Patients: A Randomized Placebo-controlled Trial

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