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Efficacy and safety of topical application of tranexamic acid in patients undergoing reconstructive plastic surgery after excision of facial skin cancers: a randomised clinical trial.
Tejada, Victor Felipe Dos Santos; Zhang, Linjie; Zogbi, Luciano.
Afiliação
  • Tejada VFDS; - Universidade Federal do Rio Grande - Rio Grande - RS - Brasil.
  • Zhang L; - Universidade Federal do Rio Grande - Rio Grande - RS - Brasil.
  • Zogbi L; - Universidade Federal do Rio Grande - Rio Grande - RS - Brasil.
Rev Col Bras Cir ; 51: e20243761, 2024.
Article em En, Pt | MEDLINE | ID: mdl-39045920
ABSTRACT

INTRODUCTION:

Tranexamic acid (TA) has attracted increased attention among surgical specialties, but its use in plastic surgery is limited. The aim of this study was to assess the efficacy and safety of topical administration of 3% TA solution in reconstructive surgery of the face and scalp after excision of skin cancers.

METHODS:

a randomized, double-blind, parallel-group clinical trial was conducted in patients aged 18 years or older with malignant skin neoplasms in the face or scalp region (ICD-10 C44.9). The primary outcome was volume of blood loss in the intraoperative and immediate postoperative period. Secondary outcomes included difficult-to-control intraoperative haemorrhage, hematoma, ecchymosis, and other adverse events.

RESULTS:

of the 54 included patients, 26 were randomised to TA group and 28 to placebo group. The mean blood loss was 11.42ml (SD 6.40, range 8.83-14.01) in the TA group, and 17.6ml (SD 6.22, range 15.19-20.01) in the placebo group, representing a mean decrease of 6.18ml (35.11%) (p=0.001). TA significantly reduced the risk of ecchymosis (RR = 0.046; 95% CI 0.007-0.323). Only two patients in the placebo group experienced ischemia in the flaps, and one patient in the placebo group experienced tissue necrosis requiring surgical reintervention. There were no surgical wound infections, thromboembolic phenomena, or other adverse events related to TA.

CONCLUSIONS:

topical TA may reduce intraoperative and immediate postoperative bleeding, with a significantly decreased risk of ecchymosis. There is no evidence of ischemic damage of flaps, systemic thromboembolic complications, or other adverse events.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Cutâneas / Ácido Tranexâmico / Neoplasias Faciais / Administração Tópica / Procedimentos de Cirurgia Plástica / Antifibrinolíticos Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En / Pt Revista: Rev Col Bras Cir Ano de publicação: 2024 Tipo de documento: Article País de publicação: Brasil

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Cutâneas / Ácido Tranexâmico / Neoplasias Faciais / Administração Tópica / Procedimentos de Cirurgia Plástica / Antifibrinolíticos Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En / Pt Revista: Rev Col Bras Cir Ano de publicação: 2024 Tipo de documento: Article País de publicação: Brasil