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Tranexamic acid in patients undergoing burn surgery: an updated meta-analysis
Jianzhen Shi1,2, Jianru Xu3, Yanmei Chen2
1Department of Science, Nantong University Xinglin College, Nantong, Jiangsu, China.
Acta Chirurgica Belgica
|September 5, 2025
Summary
Tranexamic acid (TXA) significantly reduces blood loss and packed red blood cell (PRBC) transfusions in burn surgery. While effective for bleeding control, its impact on patient recovery metrics like hospital stay requires further investigation.
Area of Science:
- Surgical Oncology
- Anesthesiology
- Trauma Surgery
Background:
- Perioperative bleeding is a significant concern in surgical procedures, impacting patient outcomes.
- Reducing blood loss during and after surgery is critical for patient safety and recovery.
- Burn surgery presents unique challenges regarding hemorrhage control.
Purpose of the Study:
- To systematically evaluate the efficacy of tranexamic acid (TXA) in mitigating blood loss during burn surgery.
- To conduct a meta-analysis assessing TXA's impact on various perioperative outcomes in burn patients.
- To determine if TXA influences transfusion requirements and hospitalization duration in this patient population.
Main Methods:
- A comprehensive literature search was conducted across major databases (PubMed, Embase, Cochrane, Web of Science).
- Seven clinical studies involving 427 patients undergoing burn surgery were included in the meta-analysis.
- Key outcomes analyzed included total blood loss, hemoglobin/hematocrit levels, PRBC transfusion needs, and hospital stay duration.
Main Results:
- TXA significantly reduced total blood loss by an average of 152.17 mL compared to controls.
- The use of TXA led to a significant decrease in packed red blood cell (PRBC) transfusions and intraoperative transfusion incidence.
- No significant differences were observed in postoperative hemoglobin, hematocrit, or length of hospital stay.
Conclusions:
- Tranexamic acid is effective in reducing perioperative blood loss and transfusion requirements in patients undergoing burn surgery.
- Further high-quality research is warranted to confirm these findings and explore potential impacts on other clinical outcomes.
- TXA represents a promising adjunct for managing hemorrhage in complex burn surgical procedures.
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