Acid in fracture surgery
Tranexamic acid (TXA) has already proven its efficacy in reducing blood loss and the need for transfusions after a number of orthopedic surgeries, but the drug’s use in orthopedic fracture surgery still remains unclear, say orthopedic surgeons. In the present study, the authors reviewed existing literature regarding the effectiveness and safety of TXA in fracture surgery. The authors found only a small number of studies available on this subject; these suggest that tranexamic acid in fracture surgery reduced total blood loss, transfusion rates and the drop of hemoglobin levels, without increasing risk of venous thromboembolism.
The literature search encompassed PubMed, Embase, OVID and the Cochrane Library; seven randomized controlled trials and cohort studies (total number of patients: 559) met the inclusion criteria. Primary outcome measures included the number of patients receiving a blood transfusion and perioperative total blood loss.
Compared to placebo, TXA significantly reduced total blood loss by approximately 330 mL (P = 0.009), it reduced the transfusion rate with a relative risk of 0.54 (P < 0.001), and decreased the drop of hemoglobin by 0.76 g/dL (P < 0.001). There was no significant difference between the number of thromboembolic events among the study groups (P = 0.24).
The study showed that tranexamic acid may be used in orthopedic fracture surgeries to reduce total blood loss, transfusion rates, and the drop in hemoglobin levels. However, the authors also caution that due to the small size of available studies, further larger studies are still needed to validate these findings.