Topical Application of Tranexamic Acid and Postoperative Blood Loss in Femoral Neck Fractures
Status:
Terminated
Trial end date:
2017-11-03
Target enrollment:
Participant gender:
Summary
Tranexamic acid (TA) is a synthetic antifibrinolytic agent. It prevents degradation of fibrin
and delays the breakdown of hemostatic clots. It has been demonstrated in multiple studies
and meta analyses to decrease blood loss in elective hip and knee arthroplasty. However,
concerns about the prothrombotic side effects of systemic administration of TA has hindered
the widespread adoption of this medication in orthopaedic patients due to their high risk for
thrombotic complications such as deep venous thrombosis and pulmonary embolism Topical
application of tranexamic acid has been proposed as a way to mitigate the potential
prothrombotic effects of TA. Topical application of TA has been demonstrated to be beneficial
in oral and cardiac surgery. Plasma levels of TA have been found to be minimal following
topical application, minimizing its potential systemic thromboembolic side effects. TA has
been used topically in total knee arthroplasty, with significant reductions in blood loss and
no increase in thromboembolic complications8,10. Data on the use of TA in hip fracture
surgery is limited, and there are no studies examining topical use of TA in hip fracture
surgery.