Role of Tranexamic Acid for Seroma Prevention in Obese Patients Undergoing Laparoscopic Ventral Hernia Repair Under Spinal Anesthesia

Abstract

Objective: The aim of this study is to determine the effectiveness of tranexamic acid for seroma prevention in obese patients undergoing laparoscopic ventral hernia repair under spinal anesthesia. Study Design: Cross sectional study Place and Duration: Jinnah Postgraduate Medical Center (JPMC) Karachi, 1st July 2020 to 30th June 2021. Methods: There were one hundred and ten patients f both genders had abdominal hernia were included in this study. We have taken written consent from all the patients for detailed demographics age, sex and body mass index. Patients were undergone for laparoscopic ventral hernia repair under spinal anesthesia in OPD. The size and contents of the defect were determined by an abdominal and pelvic ultrasound. All patients received postoperative tranexamic acid. Drains were put in to measure the amount of seroma that was produced as a result of the procedure. SPSS 22.0 was used to analyze all of the data. Results: 42.23±6.55 years were the mean age of the patients. Mean Body mass index was 32.13±3.43 kg/m2. Majority of the patients 74 (67.3%) were females and rest of the patients 36 (32.7%) were males. In 91 (82.7%) cases seroma reduction was calculated within week. Only 41 of the 110 patients had drain output of less than 150 ml, 55 had drain output of 150-300 ml, and 14 had drain output greater than 300 ml. Seroma formation was found among 7 (6.4%) cases. Conclusion: Tranexamic acid was found to be efficient in minimizing postoperative seroma formation in ventral hernia repairs, according to the findings of this study. Keywords: Laparoscopic, Tranexamic acid, Plasminogen, Seroma, Obese Patients

Evaluation of outcome of systemic tranexamic acid injection in drain output in ventral hernia repair

“…One of the most common problems are the Abdominal wall hernias with predominant cause being the increased intra-abdominal pressure (7)(8)(9)(10). In 1962, tranexamic acid was discovered, essential medicines used to treat major traumatic injuries, excessive bleeding injuries, post-partum bleeding, surgeries, bleeding from nose, removal of tooth, and heavy menstrual bleeding (8)(9)(10)(11). Tranexamic acid is an easily available drug and its cost-effective with no dose adjustment required and safe in hepatic impairment (11)(12)(13)(14)(15).…”

“…In 1962, tranexamic acid was discovered, essential medicines used to treat major traumatic injuries, excessive bleeding injuries, post-partum bleeding, surgeries, bleeding from nose, removal of tooth, and heavy menstrual bleeding (8)(9)(10)(11). Tranexamic acid is an easily available drug and its cost-effective with no dose adjustment required and safe in hepatic impairment (11)(12)(13)(14)(15). Our study therefore designed to explore use of tranexamic acid in drain output.…”

“…Also, reduced number of complications have been reported with topical use of tranexamic acid in different surgeries (10). Khan et al has also reported reduction in seroma formation in 82.7% of patients with reduced drain output (11). Tranexamic acid has anti-fibrinolytic action and limits conversion of plasminogen to plasmin and therefore reducing hemostatic fibrin from getting dissolved and stabilize fibrin, therefore reduces seroma formation.…”