Tranexamic acid as a local hemostasis method after dental extraction in patients on warfarin: a randomized controlled clinical study

Queiroz, Salomão Israel Monteiro Lourenço; Silvestre, Valéria Damasceno; Soares, Renata Monteiro; Campos, Giordano Bruno Paiva; Germano, Adriano Rocha; Silva, José Sandro Pereira da

doi:10.1007/s00784-017-2327-4

Cited by 34 publications

(42 citation statements)

References 34 publications

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“…We need to mention that, besides the fibrin, other agents used in the formulation may contribute to the haemostatic effect of our NFAH. Tranexamic acid is a procoagulant drug that has an antifibrinolytic action and has been successfully used to reduce blood loss in several types of surgery (Meng, Pan, Xiong, & Liu, ; Queiroz et al, ; Suh, Kyung, Han, Cheong, & Lee, ; Zilinsky et al, ). Indeed, it has been shown that the use of tranexamic acid and fibrinogen reduces blood loss and improves coagulation measurements in a porcine model of liver injury (Zentai et al, ).…”

Section: Discussionmentioning

confidence: 98%

Nanostructured fibrin agarose hydrogel as a novel haemostatic agent

Campos‐Cuerva

Fernández‐Muñoz

Lopez

et al. 2019

J Tissue Eng Regen Med

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Blood loss remains a major concern during surgery and can increase the morbidity of the intervention. The use of topical haemostatic agents to overcome this issue therefore becomes necessary. Fibrin sealants are promising haemostatic agents due to their capacity to promote coagulation, but their effectiveness and applicability need to be improved. We have compared the haemostatic efficacy of a novel nanostructured fibrin‐agarose hydrogel patch, with (c‐NFAH) or without cells (a‐NFAH), against two commercially available haemostatic agents in a rat model of hepatic resection. Hepatic resections were performed by making short or long incisions (mild or severe model, respectively), and haemostatic agents were applied to evaluate time to haemostasis, presence of haematoma, post‐operative adhesions to adjacent tissues, and inflammation factors. We found a significantly higher haemostatic success rate (time to haemostasis) with a‐NFAH than with other commercial haemostatic agents. Furthermore, other relevant outcomes investigated were also improved in the a‐NFAH group, including no presence of haematoma, lower adhesions, and lower grades of haemorrhage, inflammation, and necrosis in histological analysis. Overall, these findings identify a‐NFAH as a promising haemostatic agent in liver resection and likely in a range of surgical procedures.

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Section: Discussionmentioning

confidence: 98%

Nanostructured fibrin agarose hydrogel as a novel haemostatic agent

Campos‐Cuerva

Fernández‐Muñoz

Lopez

et al. 2019

J Tissue Eng Regen Med

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“…Tranexamic acid is a useful antifibrinolytic agent. A 5% solution may be applied topically with gauze over a wound for five minutes 28 or by rinsing in the mouth postoperatively for 2 min, four times daily. 29 Tranexamic acid 4.8% mouthwash can be compounded by pharmacies (Fig.…”

Section: Discussionmentioning

confidence: 99%

Dental extraction in a patient with undiagnosed Von Willebrand’s Disease: a case report

Baghaie

Forrest

Shukla

et al. 2020

Australian Dental Journal

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“…In view of this, studies investigating the local application of TXA for bleeding control have been carried out in the setting of elective total knee arthroplasty and dental surgery showing promising results. [ 34 35 36 ] However, there are no studies investigating the role of local TXA application in obtaining bleeding control in trauma patients. In the current study, using an animal model of severe liver injury, we could detect a decrease in bleeding in the cohort packed with TXA soaked gauze.…”

Section: Discussionmentioning

confidence: 99%

Local tranexamic acid for local hemostasis in an animal liver injury model

Paydar

Karami

Nezhad

et al. 2020

J Emerg Trauma Shock

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Background: Hyperfibrinolysis is a state of increased clot resolution often seen in trauma patients with ongoing hemorrhage. Tranexamic acid (TXA) inhibits fibrinolysis preventing clot resolution affecting hemorrhage continuation and is used by intravenous administration. Aims: The purpose of this study was to evaluate the local tranexamic acid application for hemostatic control in an experimental animal liver injury model. Settings and Design: This study was an experimental prospective treatment study to check the local TXA effects on liver injury. This study was approved by the Ethics Committee. Materials and Methods: Twenty adult male Sprague-Dawley white rats were equally randomized to two groups after a standardized liver injury was conducted under anesthesia. One group were “liver-packed” with gauze (TXA [−]) and the other group with gauze soaked in TXA (TXA [+]). Bleeding from the injured middle liver lobe was measured at 2 and 15 min, and at 48h second-look surgery, with euthanasia conducted at 14 days. The liver was sent for histopathological and stereological analysis. Statistical Analysis and Results: There was no difference in bleeding at 2 or 15 min after packing; however, larger amount of free blood at 48 h in the TXA (−) group was noticed. Five animals in the TXA (−) were alive at 14 days compared to eight animals in the TXA (+) group. Significantly larger volume density of fibrosis, granulation tissue, and amorphous tissue were seen in the TXA (+) group compared to the TXA (−) group at the stereological analysis. Conclusion: Local TXA application on the injured liver surface might offer better hemostatic control than packing alone. Further studies are mandated before the clinical application of our findings.

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Tranexamic acid as a local hemostasis method after dental extraction in patients on warfarin: a randomized controlled clinical study

Abstract: Thus, this measure of local hemostasis in topical form with gauze compression and irrigation was shown to be more effective in reducing the time to attain immediate hemostasis, and in preventing intermediate hemorrhage.

Cited by 34 publications

References 34 publications

Nanostructured fibrin agarose hydrogel as a novel haemostatic agent

Nanostructured fibrin agarose hydrogel as a novel haemostatic agent

Dental extraction in a patient with undiagnosed Von Willebrand’s Disease: a case report

Local tranexamic acid for local hemostasis in an animal liver injury model

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