The effect of tranexamic acid on blood loss after surgical excision in burn patients

Abstract

Background and purpose: Bleeding following surgical excision in burn patients remains a significant challenge and is recognized as an independent predictor of mortality. Meanwhile, tranexamic acid has been shown to reduce surgical bleeding by approximately .30-40 %. Given this evidence, it is essential to conduct a study comparing the effects of tranexamic acid-impregnated dressings versus plain dressings on postoperative bleeding in patients with second- and third-degree burns.

Methods: This study was a double-blind randomized clinical trial. The research population included adult patients with 2nd and 3rd degree burns and 20-50 % burn extent undergoing surgery. The sample size in this study was 30 patients for each group. Sampling was by simple random sampling and samples were randomly divided 1:1 into moistening the wound surface before closure with TXA or 0.9 % sodium chloride.

Results: In this study, there were no significant differences in demographic characteristics between the two groups. However, the mean blood loss differed significantly, with the tranexamic acid group experiencing less blood loss compared to the placebo group (p < 0.05). Furthermore, the risk of infection was significantly lower in the tranexamic acid group, with a 65 % reduction compared to the placebo group (p < 0.05). The need for blood transfusions and blood supplements also showed a significant difference (p < 0.05), as the average number of packed cells transfused was 2.64 units higher in the placebo group than in the tranexamic acid group. Despite these findings, there were no significant differences in changes in hemoglobin or hematocrit levels between the two groups.

Discussion: Based on the findings of this study, the use of tranexamic acid-soaked dressings reduced bleeding and the risk of infection after surgical excision in burn patients. However, it did not significantly affect the need for blood transfusions or changes in hemoglobin and hematocrit levels.

Keywords: Bandage; Burns; Surgical excision; Tranexamic acid.