Effect of single dose intravenous tranexamic acid on blood loss in tangential excision of burn wounds — A double blind randomised controlled trial. Issue 6 (September 2022)

• Record Type: Journal Article
• Authors: K.S., Ajai; Kumar, Parmod; Subair, Mohsina; Sharma, Ramesh Kumar
• Is Part Of: Burns. Volume 48:Issue 6(2022)
• Page Start: 1311
• Page End: 1318
• Publication Date: 2022-09
• Subjects: TXA tranexamic acid -- EBV estimated blood volume -- CBL calculated blood loss -- BMI body mass index; Tangential excision -- Tranexamic acid -- Blood loss -- Gross formula -- Blood transfusion; Burns and scalds -- Periodicals; 617.11
• DOI: 10.1016/j.burns.2021.08.021
• Languages: English
• ISSNs: 0305-4179

Abstract

Highlights: Tangential excision of burns is associated with significant blood loss during surgery. Tranexamic acid has proven to decrease blood loss in emergency and elective surgery. Tranexamic acid use reduced blood loss per square centimeter of tangential excision in burns <30%. Further studies are needed to study the effect in larger burns. Abstract: Introduction: This study was carried out to evaluate role of intravenous tranexamic acid (TXA) in reducing blood loss during tangential excision of burns. Methods: This was a single center, prospective double-blinded parallel arm superiority randomized placebo-controlled trial. Patients (15−55 years) with deep dermal thermal burns <30% undergoing tangential excision were randomly assigned (1:1) to TXA and placebo groups. Patients in TXA and placebo groups received injection TXA 15 mg/kg and 10 ml saline respectively, 10 min preoperatively. Primary outcome was volume of blood loss per square centimeter area of burn excised. Secondary outcomes were total volume of blood loss, postoperative hemoglobin, intraoperative fluid requirement, blood transfusion, graft take and length of hospitalization (LOH). Results: Thirty patients were included. Both groups were comparable in terms of Body Mass Index (BMI) preoperative hemoglobin, area of burn excised, duration of surgery and the intraoperative temperature. The average blood loss per square centimeter burn area excised was found to be significantly lower in TXA when compared to placebo group (mean difference: 0.28 ± 0.025 ml/cm 2 ; p = 0.000). The total volume of blood loss was lower in TXA group (258.7 ± 124.10 ml vs 388.1 ± 173.9 ml; p = 0.07). None of the patients required transfusion. The requirement of intra-operative fluids was similar between the two groups (crystalloids: p = 0.236; colloids: p = 0.238). Postoperative hemoglobin, length of hospitalization and graft-take were comparable between the two groups. Conclusion: TXA reduced blood loss per unit burn area of tangential excision in <30%TBSA burn, however, we found no significant effect on postoperative Hb and transfusion.