Role of Intravenous Tranexamic Acid in Prevention of Seroma Formation after Umbilical and Para Umbilical Hernioplasty

Abstract

Umbilical and paraumbilical hernias are common conditions affecting a significant portion of the global population, with surgical intervention being a common treatment modality. Seroma formation is a common complication after hernioplasty. Tranexamic acid (TXA) has emerged as a promising prophylactic agent for seroma prevention, as it inhibits fibrin breakdown, reducing blood loss and blood transfusions. Objective: To evaluate the role of intravenous tranexamic acid in the prevention of seroma formation after umbilical and paraumbilical hernioplasty. Methods: It was a cohort study conducted at the department of surgery, Kulsoom Bai Valika Hospital, Karachi, Pakistan from Oct 2022 to Apr 2022. Patients aged 18 years or above who underwent umbilical and paraumbilical hernioplasty of either gender were involved in the study. The individuals were then categorized into two groups: the exposed group, consisting of patients who received intravenous tranexamic acid (IVTXA), and the unexposed group, comprising of patients who did not receive IVTXA. Both groups were monitored for a duration of three months to assess the incidence of seroma formation. Results: Out of 30 patients in each group, 4 patients (13.3%) in the IVTXA group developed seroma, while 26 patients (86.7%) in the Without TXA group developed seroma. This difference was statistically significant with p-value=0.0021. The risk of seroma formation is 0.22 times lesser in patients with intravenous tranexamic acid as compared to patients without tranexamic acid (RR=0.22, 95% CI: 0.12-0.91). Conclusions: IVTXA may be effective in preventing seroma formation after umbilical and paraumbilical hernioplasty.