Topical Application of Tranexamic Acid Can Reduce Postoperative Blood Loss in Calcaneal Fractures: A Randomized Controlled Trial

Huang, Jikun; Guo, Hao; Huang, Weiqi; Tan, Xinyu; Huang, Huajun; Zeng, Canjun

doi:10.1053/j.jfas.2022.01.017

Cited by 7 publications

(21 citation statements)

References 12 publications

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“…The change in hemoglobin was reported by 6 studies. Huang et al 10 conducted blood tests 48 hours postoperation, and Steinmetz et al 22 checked the hemoglobin levels on postoperative day 1. The remaining 4 studies did not mention the timing of postoperative blood testing.…”

Section: Resultsmentioning

confidence: 99%

“…Out of those, 511 (67.95%) procedures received TXA whereas 241 (32.05%) served as controls and did not receive TXA. In the TXA group, 54 (10.57%) procedures received local TXA injection in 2 studies 10,28 whereas the remaining majority of 457 (89.43%) procedures received intravenous (IV) TXA. Among the control group, saline was used as a placebo in 133 (55.19%) controls in 4 studies, 2,10,26 whereas no placebo was used in the remaining 108 (44.81%) controls.…”

Section: Resultsmentioning

confidence: 99%

“…In the TXA group, 54 (10.57%) procedures received local TXA injection in 2 studies 10,28 whereas the remaining majority of 457 (89.43%) procedures received intravenous (IV) TXA. Among the control group, saline was used as a placebo in 133 (55.19%) controls in 4 studies, 2,10,26 whereas no placebo was used in the remaining 108 (44.81%) controls. The specifics of utilization of placebo control are summarized in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Three randomized control trials that reported on TXA use in calcaneal fracture fixation were included for subgroup analysis. 10,26,28 A total of 183 procedures were included. Among those, 99 (54.1%) received TXA whereas 84 (45.9%) received saline placebo.…”

Section: Resultsmentioning

confidence: 99%

“…Our subgroup analysis showed a significant decrease in EBL with a tendency toward lower complications in the TXA group. Furthermore, in the RCTs conducted by Huang et al 10 and Zhong et al, 28 in which local wound infiltration with TXA was used in the intervention group, no significant difference in wound complications was reported compared to placebo. On the other hand, Xie et al 26 reported on the use of IV TXA in open reduction and internal fixation of the calcaneum with a significantly lower wound-related complications (7.3%) compared to placebo (23.8%) ( P = .036).…”

Section: Discussionmentioning

confidence: 95%

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Tranexamic Acid Utilization in Foot and Ankle Surgery: A Meta-analysis

et al. 2022

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Background: Tranexamic acid (TXA) has been widely used in various orthopaedic subspecialities to decrease blood loss, transfusions, and wound complications. However, the role of TXA in foot and ankle surgery is not clearly delineated. This meta-analysis aims to report the efficacy and safety of TXA in relation to foot and ankle surgical procedures. Methods: Database searches were conducted for eligible studies from data inception through January 2022. Clinical studies on the use of TXA in foot and ankle procedures reporting the desired outcomes were included. Outcomes were estimated blood loss, change in hemoglobin, and overall complications. Risk of bias was assessed using the Newcastle-Ottawa quality assessment scale and the Joanna Briggs Institute (JBI) critical appraisal tool. Results: Nine studies met the inclusion criteria. A total of 752 foot and ankle procedures were included, in which 511 (67.95%) procedures received TXA whereas 241 (32.05%) served as controls and did not receive TXA. The pooled data of change in hemoglobin and overall complications showed no difference between the TXA and control group. Estimated blood loss was significantly lower in the patients who received TXA. Conclusion: In conclusion, TXA use was associated with lower estimated blood loss in foot and ankle surgeries without increased risk of thromboembolic events, wound complications, or changes in hemoglobin. Level of Evidence: Level IV, Meta-analysis.

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Section: Resultsmentioning

confidence: 99%