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Subcutaneous Injection of Tranexamic Acid to Reduce Bleeding During Dermatologic Surgery: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial

Citation

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]

Copyright Statement

2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved

DOI: doi:10.1097/DSS.0000000000001786

Abstract

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 Details

Item Type:Refereed Article
Keywords:Tranexamic acid; hemostasis; anticoagulants; Mohs micrographic surgery
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Surgery
Objective Division:Health
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)
ID Code:130327
Year Published:2019
Deposited By:Health Sciences
Deposited On:2019-01-21
Last Modified:2019-03-22
Downloads:0

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