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Subcutaneous injection of tranexamic acid to reduce bleeding during dermatologic surgery: A double-blind, placebo-controlled, randomized clinical trial
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, 45 pp. 759-767. ISSN 1076-0512 (2019) [Refereed Article]
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© 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved. This is a non-final version of an article published in final form as the article cited above.
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:||Biomedical and Clinical Sciences|
|Research Group:||Clinical sciences|
|Objective Group:||Clinical health|
|Objective Field:||Treatment of human diseases and conditions|
|UTAS Author:||Visentin, D (Dr Denis Visentin)|
|UTAS Author:||Ahuja, K (Dr Kiran Ahuja)|
|Web of Science® Times Cited:||16|
|Deposited By:||Health Sciences|
|Downloads:||17 View Download Statistics|
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