The effect of antifibrinolytic agents on wound healing

Björlin, G; Nilsson, Inga Marie

doi:10.1016/s0901-5027(88)80056-0

Cited by 21 publications

(17 citation statements)

References 5 publications

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“…Interestingly, the lysine analogues tranexamic acid and epsilon-aminocaproic acid, which are known inhibitors of plasminogen, exhibit opposing effects on wound healing; tranexamic acid promotes wound healing, whereas epsilon-aminocaproic acid inhibits wound healing. It is likely that these effects are independent of their antifibrinolytic properties [22].…”

Section: Discussionmentioning

confidence: 99%

Promotion of Wound Healing by an Agonist of Adenosine A2A Receptor Is Dependent on Tissue Plasminogen Activator

Desai-Merchant

Cronstein

2015

Inflammation

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Impaired wound healing, as it occurs in diabetes mellitus or long-term corticoid treatment, is commonly associated with disability, diminished quality of life, and high economic costs. Selective agonists of the A2A receptor subtype of adenosine, an endogenous regulator of inflammation, promote tissue repair in animal models, both healthy and with impaired healing. Plasmin-mediated proteolysis of fibrin and other matrix proteins is essential for cell migration at sites of injury. Since adenosine A2A receptor activation increases plasminogen activator release from macrophages and mast cells, we studied the effect of a selective agonist, CGS-21680, on full-thickness excisional wound closure in wild-type, urokinase plasminogen activator (uPA)-deficient, and tissue plasminogen activator (tPA)-deficient mice. Wound closure was impaired in tPA- and uPA-deficient mice as compared with wild-type mice, and topical application of CGS-21680 significantly increased the rate at which wounds closed in wild-type mice and uPA-deficient mice, but not in tPA-deficient mice. Immunostaining of tissue sections showed that tPA was present in endothelial cells and histiocytes by day 3 post-wound and also by day 6. In contrast, uPA was more prominent in these cell types only by day 6 post-wound. Our results confirm that plasminogen activation contributes to wound repair and are consistent with the hypothesis that adenosine A2A receptor activation promotes wound closure by a mechanism that depends upon tPA, but not uPA. Moreover, our results suggest that topical adenosine A2A receptor agonists may be useful in promotion of wound closure in patients with impaired wound healing.

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Section: Discussionmentioning

confidence: 99%

Promotion of Wound Healing by an Agonist of Adenosine A2A Receptor Is Dependent on Tissue Plasminogen Activator

Desai-Merchant

Cronstein

2015

Inflammation

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“…Several authors also confirmed the direct positive effect of TA on wound healing and skin regeneration. [16,17] They showed that antifibrinolytic agents increase collagen synthesis and tensile strength within granulation tissue, presumably by preserving the fibrin matrix. Allogeneic blood transfusion is associated with an increased risk of surgical site infection and PJI.…”

Section: Discussionmentioning

confidence: 99%

Tranexamic acid decreases the risk of revision for acute and delayed periprosthetic joint infection after total knee replacement

et al. 2020

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This study aims to analyze the effect of intravenous administration of tranexamic acid (TA) on reducing the risk of revision for acute and delayed periprosthetic joint infection (PJI) after primary total knee replacement (TKR). Patients and methods: This prospective observational cohort study included 1,529 TKRs (396 males, 1,133 females; mean age 67.8 years; range, 44 to 85.1 years) performed between January 2003 and October 2017. We analyzed the revision rate for acute and delayed PJI in a group of 787 TKRs with preoperatively intravenously administered TA (TA group) in comparison with a group of 742 TKRs without administration of TA (non-TA group). Multiple logistic regression analysis was used to evaluate significant predictors of TKR revision for acute and delayed PJI. Results: Revision surgery due to PJI was recorded in one patient in the TA group and eight patients in the non-TA group. Cumulative revision rate of TKR was significantly lower in the TA group (0.13% vs. 1.08%, hazard ratio 0.113; 95% confidence interval [CI] 0.0147-0.937; p=0.043). Multivariate logistic regression analysis confirmed two predictors of revision: being aged over 75 years at the time of primary surgery (odds ratio [OR] 8.464; 95% CI: 2.016-35.54; p=0.004) and male gender (OR: 7.9; 95% CI: 1.879-33.26; p=0.005). The use of TA was shown as the significant protective factor (OR: 0.109; 95% CI: 0.0128-0.929; p=0.043). Conclusion: We have found a lower cumulative revision rate of TKR for acute and delayed PJI when TA was used. We think that the preoperative intravenous use of TA may be an effective, safe and inexpensive method for the prevention of PJI.

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“…Although some studies suggested that TXA may have adverse effects on tendon healing 21 , several authors advocated the positive role of TXA on wound healing and skin regeneration. Björlin et al 22 studied the effect of epsilon-aminocaproic acid and TXA on wound healing in white rats. Wounds injected with tranexamic acid had a higher tensile strength than those pre-treated with epsilon-aminocaproic acid.…”

Section: Discussionmentioning

confidence: 99%

The use of Tranexamic Acid in Total Elbow Replacement to Reduce Post-Operative Wound Infection

Mannan¹,

Ali²,

Mazur³

et al. 2018

J. Bone Joint Infect.

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Background: Incidence of infection following total elbow replacement (TER) is recognised to be higher compared to hip or knee arthroplasty. Extensive swelling following TER can complicate the wound healing which might lead to infection. Tranexamic Acid (TXA) is proven to reduce blood loss peri-operatively which might contribute to better healing outcomes. Our aim is to assess the effect of TXA in wound healing following TER.Methods: A retrospective review of a single surgeon case series. 10 patients had TER mainly for complicated elbow fractures, four of them were relatively immune-supressed. All patients had 2 grams of TXA and antibiotics intra-operatively. All were reviewed at two weeks following surgery for wound check and removal of surgical clips.Results: Seven females and three males with a mean age of 81.5 had TER and TXA. The mean level of pre-operative haemoglobin was 134.40 g/l and the mean post-operative level was 122.70g/l. No patient in this series required blood transfusion. At two weeks and six weeks follow-up, all wound healed up with no signs of infection.Conclusion: TXA has been proven to be safe an effective way of reducing peri-operative bleeding. TXA maintains haemostasis after releasing the tourniquet and therefore reduces the swelling and wound complications post-operatively

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The effect of antifibrinolytic agents on wound healing

Cited by 21 publications

References 5 publications

Promotion of Wound Healing by an Agonist of Adenosine A2A Receptor Is Dependent on Tissue Plasminogen Activator

Promotion of Wound Healing by an Agonist of Adenosine A2A Receptor Is Dependent on Tissue Plasminogen Activator

Tranexamic acid decreases the risk of revision for acute and delayed periprosthetic joint infection after total knee replacement

The use of Tranexamic Acid in Total Elbow Replacement to Reduce Post-Operative Wound Infection

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