Efficacy and Safety of Tranexamic Acid in Bimaxillary Orthognathic Surgery

Sun, Liang; Guo, Rui; Feng, Yi

doi:10.1177/2292550320925897

Cited by 10 publications

(4 citation statements)

References 29 publications

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“…Only 25% of respondents utilize TXA despite multiple meta-analyses documenting a decrease in blood loss and improvement in surgical field with the use of TXA in orthognathic surgery. [19][20][21][22][23][24] Twenty-seven percent of respondents do not use a foley catheter. The American College of Surgeons National Safety and Quality Improvement Project best practices guidelines for limiting catheter associated urinary tract infections limits perioperative use to selected surgical parameters.…”

Section: Discussionmentioning

confidence: 99%

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Current Orthognathic Surgery Practice Patterns Among Academic OMS

Bourne

Kinard

2023

The Cleft Palate Craniofacial Journal

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Objective Currently there is variation in perioperative care of orthognathic surgery patients and limited clinical practice guidelines. The current orthognathic surgery practice patterns among US academic OMFS training centers have not been described. The purpose of this study is to describe the practice patterns among US academic OMFS training centers. Design The study design is cross-sectional. Data was collected through a survey of the sample. Setting OMFS programs in the US. Participants Academic OMFS. 573 surgeons were contacted and 85 responses were received. Main Outcome Measure Descriptive and bivariate statistics were reported. Results Respondents were 87% male and worked in full-time academic (80%), part-time academic (19%), or military settings (1%). Thirty-one percent have practiced for 30 years or more and then 29% with 11–20 years, 18% with 21–30 years, 12% with 6–10 years and 11% with 1–5 years. Twenty-six percent of respondents perform 20–40 orthognathic surgeries a year, 22% perform less than 20 surgeries a year, 21% perform 40–60 surgeries per year, and 19% perform more than 100 surgeries per year. Intraoperatively, 48% of surgeons request a mean arterial pressure of 60–64 mmHg, 25% utilize tranexamic acid (TXA), 85% report a blood loss of less than 400 milliliters, and 93% report a blood transfusion rate of <1%. Conclusion There are variations in orthognathic surgery practice patterns with limited clinical practice guidelines. Only 13 of the 32 survey questions had a single response holding a simple majority. This study demonstrates the need for further research and evidence-based protocols and decision making.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Current Orthognathic Surgery Practice Patterns Among Academic OMS

Bourne

Kinard

2023

The Cleft Palate Craniofacial Journal

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“…3 Since that time and with increased use, it has been shown to have a beneficial impact on blood loss, rate of transfusion, and length of operations in elective orthopedic, gynecology, cardiac, and neurosurgical procedures. 6,8,[20][21][22][23] This review summarizes the current state of evidence for the use of tranexamic acid in craniofacial and orthognathic surgery. The number of rigorous RCTs which specifically evaluated the use of TXA in craniofacial and orthognathic surgeries are limited and this review identified only 6 studies.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy of Tranexamic Acid in Pediatric Craniofacial and Orthognathic Surgery: A Meta-Analysis

Al-Shaqsi

Senkaiahliyan

Forrest

et al. 2022

FACE

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Craniofacial and orthognathic surgery are high risk procedures for surgical blood loss. Significant blood loss leads to increased rates of blood product transfusion which may be associated with increased morbidity to the patient. The use of anti-fibrinolytics such as tranexamic acid has become popular in these procedures. However, the evidence to support its use in pediatric craniofacial and orthognathic surgery is sparse. This review analyzes the current randomized control trials assessing the use of tranexamic acid in craniofacial and orthognathic surgery. The study reviewed published literature up until December 20th, 2020. Six trials were included in this analysis. Pooled data showed that patients who received tranexamic acid during craniofacial or orthognathic surgery have less blood loss compared to those in control groups (mean difference—5.47 ml/kg [CI -7.02-3.82], P value <.05). Hence, rate of blood product transfusion in patients who received tranexamic acid is lower than control group by 2.01 ml/kg (CI 95%, 1.27-2.74, P value <.05). In summary, this review showed that craniofacial and orthognathic surgery patients who receive tranexamic acid might have lower estimated blood loss and receive less volume of blood products transfusion.

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