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Use of Topical Tranexamic Acid to Reduce Blood Loss in Single-Level Transforaminal Lumbar Interbody Fusion
STUDY DESIGN: Nonrandomized, prospective, and case-controlled study. PURPOSE: To evaluate the efficacy and cost-effectiveness of topically applied tranexamic acid (TXA) during different phases of spine surgery. OVERVIEW OF LITERATURE: Perioperative blood loss is the leading cause of postoperative an...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Korean Society of Spine Surgery
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7595815/ https://www.ncbi.nlm.nih.gov/pubmed/32213797 http://dx.doi.org/10.31616/asj.2019.0134 |
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author | Mallepally, Abhinandan Reddy Mahajan, Rajat Rustagi, Tarush Goel, Shakti Amar Das, Kalidutta Chhabra, Harvinder Singh |
author_facet | Mallepally, Abhinandan Reddy Mahajan, Rajat Rustagi, Tarush Goel, Shakti Amar Das, Kalidutta Chhabra, Harvinder Singh |
author_sort | Mallepally, Abhinandan Reddy |
collection | PubMed |
description | STUDY DESIGN: Nonrandomized, prospective, and case-controlled study. PURPOSE: To evaluate the efficacy and cost-effectiveness of topically applied tranexamic acid (TXA) during different phases of spine surgery. OVERVIEW OF LITERATURE: Perioperative blood loss is the leading cause of postoperative anemia associated with prolonged stays in hospital and long recovery times. The direct and indirect costs involved pose a significant economic challenge in developing countries. There is no consensus for topical use of tranexamic acid in spine surgery. METHODS: Patients requiring a single-level TLIF were divided into two groups. In the TXA group (n=75), the wound surface was soaked with TXA (1 g in 100 mL saline solution) for 3 minutes after exposure, after decompression, and before wound closure, and in the control group (n=175) using only saline. Intraoperative blood loss drain volume was recorded on each of the first 2 days immediately after surgery. An estimated cost analysis was made on the basis of the length of hospital stay and the blood transfusion. RESULTS: IBL for the control group was 783.33±332.71 mL and for intervention group 410.57±189.72 mL (p<0.001). The operative time for control group was 3.24±0.38 hours and for intervention group 2.99±0.79 hours (p<0.695). Hemovac drainage on days 1 and 2 for control group was 167.10±53.83 mL and 99.33±37.5 mL, respectively, and for intervention group 107.03±44.37 mL and 53.38±21.99 mL, respectively (p<0.001). The length of stay was significantly shorter in the intervention group (4.8±1.1 days) compared to control group (7.0±2.3 days). The cost of treatment in the intervention group was US dollar (USD) 4,552.57±1,222.6 compared with that in the control group USD 6,529.9±1,505.04. CONCLUSIONS: Topical TXA is a viable, cost-effective method of decreasing perioperative blood loss in major spine surgery with fewer overall complications than other methods. Further studies are required to find the ideal dosage and timing. |
format | Online Article Text |
id | pubmed-7595815 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Korean Society of Spine Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-75958152020-11-03 Use of Topical Tranexamic Acid to Reduce Blood Loss in Single-Level Transforaminal Lumbar Interbody Fusion Mallepally, Abhinandan Reddy Mahajan, Rajat Rustagi, Tarush Goel, Shakti Amar Das, Kalidutta Chhabra, Harvinder Singh Asian Spine J Clinical Study STUDY DESIGN: Nonrandomized, prospective, and case-controlled study. PURPOSE: To evaluate the efficacy and cost-effectiveness of topically applied tranexamic acid (TXA) during different phases of spine surgery. OVERVIEW OF LITERATURE: Perioperative blood loss is the leading cause of postoperative anemia associated with prolonged stays in hospital and long recovery times. The direct and indirect costs involved pose a significant economic challenge in developing countries. There is no consensus for topical use of tranexamic acid in spine surgery. METHODS: Patients requiring a single-level TLIF were divided into two groups. In the TXA group (n=75), the wound surface was soaked with TXA (1 g in 100 mL saline solution) for 3 minutes after exposure, after decompression, and before wound closure, and in the control group (n=175) using only saline. Intraoperative blood loss drain volume was recorded on each of the first 2 days immediately after surgery. An estimated cost analysis was made on the basis of the length of hospital stay and the blood transfusion. RESULTS: IBL for the control group was 783.33±332.71 mL and for intervention group 410.57±189.72 mL (p<0.001). The operative time for control group was 3.24±0.38 hours and for intervention group 2.99±0.79 hours (p<0.695). Hemovac drainage on days 1 and 2 for control group was 167.10±53.83 mL and 99.33±37.5 mL, respectively, and for intervention group 107.03±44.37 mL and 53.38±21.99 mL, respectively (p<0.001). The length of stay was significantly shorter in the intervention group (4.8±1.1 days) compared to control group (7.0±2.3 days). The cost of treatment in the intervention group was US dollar (USD) 4,552.57±1,222.6 compared with that in the control group USD 6,529.9±1,505.04. CONCLUSIONS: Topical TXA is a viable, cost-effective method of decreasing perioperative blood loss in major spine surgery with fewer overall complications than other methods. Further studies are required to find the ideal dosage and timing. Korean Society of Spine Surgery 2020-10 2020-03-30 /pmc/articles/PMC7595815/ /pubmed/32213797 http://dx.doi.org/10.31616/asj.2019.0134 Text en Copyright © 2020 by Korean Society of Spine Surgery This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Study Mallepally, Abhinandan Reddy Mahajan, Rajat Rustagi, Tarush Goel, Shakti Amar Das, Kalidutta Chhabra, Harvinder Singh Use of Topical Tranexamic Acid to Reduce Blood Loss in Single-Level Transforaminal Lumbar Interbody Fusion |
title | Use of Topical Tranexamic Acid to Reduce Blood Loss in Single-Level Transforaminal Lumbar Interbody Fusion |
title_full | Use of Topical Tranexamic Acid to Reduce Blood Loss in Single-Level Transforaminal Lumbar Interbody Fusion |
title_fullStr | Use of Topical Tranexamic Acid to Reduce Blood Loss in Single-Level Transforaminal Lumbar Interbody Fusion |
title_full_unstemmed | Use of Topical Tranexamic Acid to Reduce Blood Loss in Single-Level Transforaminal Lumbar Interbody Fusion |
title_short | Use of Topical Tranexamic Acid to Reduce Blood Loss in Single-Level Transforaminal Lumbar Interbody Fusion |
title_sort | use of topical tranexamic acid to reduce blood loss in single-level transforaminal lumbar interbody fusion |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7595815/ https://www.ncbi.nlm.nih.gov/pubmed/32213797 http://dx.doi.org/10.31616/asj.2019.0134 |
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