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

Seyed Muhammad Mehdi Ghaffari Hamedani; Ali Akbari; Sohrab Sayaydi; Zakaria Zakariaei; Mahmood Moosazadeh; Javad Boskabadi; Mahshid Naserifar; Saeed Kargar Soliemanabad

doi:10.1016/j.amsu.2021.102683

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

Ann Med Surg (Lond). 2021 Aug 10:69:102683. doi: 10.1016/j.amsu.2021.102683. eCollection 2021 Sep.

Authors

Seyed Muhammad Mehdi Ghaffari Hamedani¹, Ali Akbari², Sohrab Sayaydi², Zakaria Zakariaei³, Mahmood Moosazadeh⁴, Javad Boskabadi⁵, Mahshid Naserifar⁶, Saeed Kargar Soliemanabad⁷

Affiliations

¹ Department of Surgery, Toxoplasmosis Research Center, Communicable Diseases Institute, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
² Department of Surgery, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
³ Toxicology and Forensic Medicine Division, Toxoplasmosis Research Center, Communicable Diseases Institute, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
⁴ Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.
⁵ Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.
⁶ Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
⁷ Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.

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.

Keywords: Hematoma; Infection; Inguinal hernia; Seroma; Tranexamic acid.