Zilinsky, I and Barazani, TB and Visentin, D and Ahuja, K and Martinowitz, U and Haik, J, Subcutaneous Injection of Tranexamic Acid to Reduce Bleeding During Dermatologic Surgery: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial, Dermatologic Surgery ISSN 1076-0512 (2019) [Refereed Article]
© 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved
Background: Topical application, oral, and IV injection of tranexamic acid (TXA) have been used to reduce surgical bleeding.
Objective: To evaluate the safety and efficacy of TXA injected subcutaneously to reduce bleeding during dermatologic surgery.
Methods: In this double-blinded, placebo-controlled, randomized prospective study, 131 patients were randomized to subcutaneous injection of lidocaine 2% diluted 1:1 with either saline (placebo) or TXA 100 mg/1 mL before surgery. Before the second stage or closure, size measurements of bloodstain impregnation on Telfa and surgical wound size were recorded and analyzed using mixed-effects linear regression. Subjective evaluation of hemostasis was performed using 4-point scale grading and analyzed using Fischer's exact test.
Results: One hundred twenty-seven patients completed the study. The bloodstain to surgical wound size ratio was smaller in the TXA group (1.77) compared with the placebo group (2.49) (p < .001). An improved effect of TXA on bleeding was observed in the subgroup of patients receiving anticoagulants (mean difference; 95% confidence interval; -0.83; -1.20 to -0.46 p < .001). The subjective hemostasis assessment was significantly better in the TXA group overall (p = .043) and anticoagulant subgroup (p = .001) compared with the placebo group.
Conclusion: Subcutaneous injection of TXA was safe, reduced bleeding during dermatologic surgery, and particularly effective for patients receiving anticoagulation treatment.
|Item Type:||Refereed Article|
|Keywords:||Tranexamic acid; hemostasis; anticoagulants; Mohs micrographic surgery|
|Research Division:||Medical and Health Sciences|
|Research Group:||Clinical Sciences|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Surgical Methods and Procedures|
|UTAS Author:||Visentin, D (Dr Denis Visentin)|
|UTAS Author:||Ahuja, K (Dr Kiran Ahuja)|
|Deposited By:||Health Sciences|
Repository Staff Only: item control page