EFFICACY OF PRE-DEBRIDEMENT INTRAVENOUS TRANEXAMIC ACID IN REDUCING INTRAOPERATIVE BLOOD LOSS DURING BURN WOUND DEBRIDEMENT: A RANDOMIZED CONTROLLED TRIAL

Abstract

Objectives: To identify if tranexamic acid (TXA) prevents excess intraoperative blood loss and reduces the need for blood transfusions among patients having burn wound debridement.

Study design: Single-blinded, randomized-controlled trials

Study setting and duration: Burn Unit, Holy Family Hospital Rawalpindi, from April 2025 till  June 2025

Methods: 100 adult patients with burns covering at least 20% of their total body surface area who were treated by debridement of their burns. Each participant was randomly assigned to either the TXA group or the control group. The primary outcome measures were the amount of blood lost during surgery and the change in hemoglobin levels. Data was analyzed using SPSS. Continuous variables reported as mean ± S.D or median (IQR) and categorical as frequencies and percentages. Chi-square test and Mann-Whitney U test were applied to compare outcomes.

Results: The amount of blood lost by patients receiving TXA (694.10 (375.0)) was significantly smaller than control (938.05 (498.9); p-value < 0.001), and the change in hemoglobin level was also significantly less among patients receiving TXA (1.60 (6.30)) compared to control (3.40 (5.53) p-value < 0.001. The intervention group needed significantly fewer blood transfusions (TXA: 18% versus usual care: 78%; p-value < 0.001); however, there were also significantly fewer total AEs in the TXA group (4% versus 16%; p-value = 0.046).

Conclusion: IV TXA before surgery can greatly minimize bleeding during surgery as well as the amount of blood to be transfused.