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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, Barazani, TB, Visentin, D ORCID: 0000-0001-9961-4384, Ahuja, K ORCID: 0000-0002-0323-4692, Martinowitz, U and Haik, J 2019 , 'Subcutaneous Injection of Tranexamic Acid to Reduce Bleeding During Dermatologic Surgery: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial' , Dermatologic Surgery , doi: 10.1097/DSS.0000000000001786.

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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 Conclusion:Subcutaneous injection of TXA was safe, reduced bleeding during dermatologic surgery, and particularly effective for patients receiving anticoagulation treatment.

Item Type: Article
Authors/Creators:Zilinsky, I and Barazani, TB and Visentin, D and Ahuja, K and Martinowitz, U and Haik, J
Keywords: Tranexamic acid; hemostasis; anticoagulants; Mohs micrographic surgery
Journal or Publication Title: Dermatologic Surgery
Publisher: Blackwell Publishing Inc
ISSN: 1076-0512
DOI / ID Number: 10.1097/DSS.0000000000001786
Copyright Information:

© 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.

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