Subcutaneous Injection of Tranexamic Acid to Reduce Bleeding During Dermatologic Surgery: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial.
Dermatol Surg
; 45(6): 759-767, 2019 06.
Article
em En
| MEDLINE
| ID: mdl-30640775
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 11 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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ácido Tranexâmico
/
Perda Sanguínea Cirúrgica
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Hemorragia Pós-Operatória
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Procedimentos Cirúrgicos Dermatológicos
/
Antifibrinolíticos
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Observational_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Dermatol Surg
Assunto da revista:
DERMATOLOGIA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Israel