The topical application of tranexamic acid to control bleeding in inguinal hernia surgery candidate patients: A randomized controlled trial

Abstract

Background and objectives Inguinal hernia surgery is a common procedure, especially for the elderly, who usually use anticoagulants and antiplatelet drugs. In this study, we evaluated the effectiveness of tranexamic acid (TXA) on the complications of inguinal hernia repair in patients using antiplatelets. Patients and methods This study is a randomized controlled trial that was performed during the 2018–2019 years. Forty patients with inguinal hernia and antiplatelet use were enrolled randomly into the two groups. In the intervention group, the patients received two injectable form (500mg/5 mL) of TXA, totally 10 mL as a topical application at the surgical site, and then the patient's surgical site was seen every 8 h for 48 h, and the patient was examined daily for one week. Results The mean length of hospitalization, seroma, hematoma and infection in the two groups were not statistically significant (P > 0.05). However, the duration of surgery in the TXA group was significantly shorter than in the control group (54.85 vs. 68.72 min) (P < 0.001). The mean bleeding during surgery was significantly lower in the TXA group than in the control group (P < 0.001). Conclusion The findings of present study indicate that topical TXA has a high ability to control bleeding. As a result, TXA is beneficial in terms of reducing bleeding and increasing the surgeon's satisfaction. Therefore, it is recommended that TXA be prescribed for patients requiring inguinal hernia surgery with a high risk of bleeding.

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).…”

“…Recently (in 2023) a cross-sectional study by Tarar et al has shown reduced risk of seroma formation in patients with ventral hernia, where in 81% of the patients seroma formation was improved within 5 days (9). 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).…”

The effect of tranexamic acid on myocardial injury in cardiac surgical patients: a systematic review and meta-analysis

“…TXA has been widely administered among patients with bleeding disorders, trauma and among patients undergoing various types of surgery, for example, osteotomy, obstetrics, cardiovascular surgery, and hernia surgery [6,[15][16][17][18]. However, evidence suggested that TXA administration was found to be associated with increased risk of myocardial ischemia/infarction and other thrombotic complications (e.g.…”