Tranexamic acid in patients undergoing burn surgery: an updated meta-analysis

Surgical procedures often entail significant blood loss, potentially leading to various complications. Thus, reducing perioperative bleeding is crucial to enhancing patient outcomes. This study systematically evaluates and conducts a meta-analysis on the efficacy of tranexamic acid (TXA) in patients undergoing burn surgery.

A comprehensive literature search was performed across PubMed, the Cochrane Central Register of Controlled Trials, Embase, and Web of Science databases to identify pertinent clinical studies on the application of TXA in burn-related surgical procedures. The evaluated outcomes included total blood loss, postoperative hemoglobin levels, postoperative hematocrit, intraoperative packed red blood cell (PRBC) transfusion units, incidence of intraoperative transfusion, and duration of hospitalization.

The analysis incorporated seven studies with a total of 427 patients. Compared to the control group, TXA was associated with a significant reduction in total blood loss [MD = -152.17 mL (95% CI: -159.48 to -144.87)], total PRBC units transfused [MD = -0.61 units (95% CI: -0.92 to -0.30)], and intraoperative transfusion incidence [logRR = -0.70 (95% CI: -1.04 to -0.35)]. However, there were no significant differences observed in postoperative hemoglobin levels [MD = 0.47 g/dL (95% CI: -0.12 to 1.06)], postoperative hematocrit [MD = 2.13% (95% CI: -0.66 to 4.92)], or length of hospital stay [MD = -2.80 days (95% CI: -6.44 to 0.83)].

TXA appears to effectively reduce blood loss and the requirement for PRBC transfusions in burn surgery. Further high-quality research is necessary to substantiate these findings.Abbreviations: TXA: tranexamic acid; PRBC: packed red blood cell; MD: mean difference; REML: restricted maximum likelihood; logOR: log odds ratio.