Role of Intravenous Tranexamic Acid in Prevention of Seroma Formation after Umbilical and Para Umbilical Hernioplasty
Role of Intravenous Tranexamic Acid
DOI:
https://doi.org/10.54393/pjhs.v4i09.910Keywords:
Intravenous Tranexamic Acid, Hernia, Hernioplasty, Seroma Formation, Umbilical Hernia, Paraumbilical HerniaAbstract
Umbilical and paraumbilical hernias are common conditions affecting a significant portion of the global population, with surgical intervention being a common treatment modality. Seroma formation is a common complication after hernioplasty. Tranexamic acid (TXA) has emerged as a promising prophylactic agent for seroma prevention, as it inhibits fibrin breakdown, reducing blood loss and blood transfusions. Objective: To evaluate the role of intravenous tranexamic acid in the prevention of seroma formation after umbilical and paraumbilical hernioplasty. Methods: It was a cohort study conducted at the department of surgery, Kulsoom Bai Valika Hospital, Karachi, Pakistan from Oct 2022 to Apr 2022. Patients aged 18 years or above who underwent umbilical and paraumbilical hernioplasty of either gender were involved in the study. The individuals were then categorized into two groups: the exposed group, consisting of patients who received intravenous tranexamic acid (IVTXA), and the unexposed group, comprising of patients who did not receive IVTXA. Both groups were monitored for a duration of three months to assess the incidence of seroma formation. Results: Out of 30 patients in each group, 4 patients (13.3%) in the IVTXA group developed seroma, while 26 patients (86.7%) in the Without TXA group developed seroma. This difference was statistically significant with p-value=0.0021. The risk of seroma formation is 0.22 times lesser in patients with intravenous tranexamic acid as compared to patients without tranexamic acid (RR=0.22, 95% CI: 0.12-0.91). Conclusions: IVTXA may be effective in preventing seroma formation after umbilical and paraumbilical hernioplasty.
References
Sanna A and Felicioni L. Paraumbilical/Umbilical Hernia. Abdominal Surgery. 2021 Feb. doi: 10.5772/intechopen.96186. DOI: https://doi.org/10.5772/intechopen.96186
Konaté I, Ndong A, Tendeng JN. Umbilical hernias in adults: epidemiology, diagnosis and treatment. InThe Art and Science of Abdominal Hernia. IntechOpen. 2020 Dec.
Albatanony A, Shahin M, Fayed A, El Shemi A. The effect of intravenous tranexamic acid on reduction of seroma after para-umbilical hernioplasty. International Surgery Journal. 2019 Jun; 6(7): 2290-4. doi: 10.18203/2349-2902.isj20192949. DOI: https://doi.org/10.18203/2349-2902.isj20192949
Lashari A, Mirani SH, Bozdar AG, Shar ZA, Malik A. Effectiveness of Tranexamic Acid for Prevention of Postoperative Seroma Formation in Patients Undergoing Ventral Hernioplasty. Pakistan Journal Of Medical And Health Sciences 2020 Dec; 14(4): 1143-5.
Ahmed H. Seroma reduction and role of tranexamic acid in ventral hernia repair. Journal of Surgery Pakistan. 2020 Nov; 25(2): 89-92.
Zubair R, Mirza MR, Habib L, Iftikhar J, Zehra B. Role of tranexamic acid in prevention of seroma formation after ventral hernioplasty. Pak Journal of Surgery. 2020 Apr; 36(2): 126-9.
Ockerman A, Vanassche T, Garip M, Vandenbriele C, Engelen MM, Martens J, et al. Tranexamic acid for the prevention and treatment of bleeding in surgery, trauma and bleeding disorders: a narrative review. Thrombosis Journal. 2021 Dec; 19(1): 1-6. doi: 10.1186/s12959-021-00303-9. DOI: https://doi.org/10.1186/s12959-021-00303-9
UK Royal Colleges Tranexamic Acid in Surgery Implementation Group, Grocott MP, Murphy M, Roberts I, Sayers R, Toh CH. Tranexamic acid for safer surgery: the time is now. British Journal of Surgery. 2022 Dec; 109(12): 1182-3. doi: 10.1093/bjs/znac252. DOI: https://doi.org/10.1093/bjs/znac252
Cai J, Ribkoff J, Olson S, Raghunathan V, Al‐Samkari H, DeLoughery TG, et al. The many roles of tranexamic acid: an overview of the clinical indications for TXA in medical and surgical patients. European Journal of Haematology. 2020 Feb; 104(2): 79-87. doi: 10.1111/ejh.13348. DOI: https://doi.org/10.1111/ejh.13348
Gupta K, Rastogi B, Krishan A, Gupta A, Singh VP, Agarwal S. The prophylactic role of tranexamic acid to reduce blood loss during radical surgery: A prospective study. Anesthesia, Essays and Researches. 2012 Jan; 6(1): 70. doi: 10.4103/0259-1162.103378. DOI: https://doi.org/10.4103/0259-1162.103378
Hagbevor I, Ali MA, Awuku GA. Closed non-suction drain placement as haematoma and seroma formation preventive measure post-nylon darn surgery for inguinoscrotal hernias in adults. Hernia. 2022 Feb; 26(1): 123-30. doi: 10.1007/s10029-021-02430-8. DOI: https://doi.org/10.1007/s10029-021-02430-8
Zhang B, He L, Yao Y. Intravenous Tranexamic Acid Reduces Post-Operative Bleeding and Blood Transfusion in Patients Undergoing Aortic Surgery: A PRISMA-Compliant Systematic Review and Meta-Analysis. Reviews in Cardiovascular Medicine. 2023 Apr; 24(4): 120. doi: 10.31083/j.rcm2404120. DOI: https://doi.org/10.31083/j.rcm2404120
Calpin GG, McAnena PF, Davey MG, Calpin P, Kerin MJ, McInerney N, Walsh SR, Lowery AJ. The role of tranexamic acid in reducing post-operative bleeding and seroma formation in breast surgery: A meta-analysis. The Surgeon. 2022 Dec; 21(4):e183-e94. doi: 10.1016/j.surge.2022.11.005. DOI: https://doi.org/10.1016/j.surge.2022.11.005
Colomina MJ, Contreras L, Guilabert P, Koo M, Méndez E, Sabate A. Clinical use of tranexamic acid: evidences and controversies. Brazilian Journal of Anesthesiology. 2022 Oct; 72: 795-812. doi: 10.1016/j.bjane.2021.08.022. DOI: https://doi.org/10.1016/j.bjane.2021.08.022
Nishida T, Kinoshita T, Yamakawa K. Tranexamic acid and trauma-induced coagulopathy. Journal of Intensive Care. 2017 Dec; 5(1): 1-7. doi: 10.1186/s40560-016-0201-0. DOI: https://doi.org/10.1186/s40560-016-0201-0
Scarafoni EE. A systematic review of tranexamic acid in plastic surgery: what’s new? Plastic and Reconstructive Surgery Global Open. 2021 Mar; 9(3): e3172. doi: 10.1097/GOX.0000000000003172. DOI: https://doi.org/10.1097/GOX.0000000000003172
Weissler JM, Kuruoglu D, Antezana L, Curiel D, Kerivan L, Alsayed A, et al. Efficacy of tranexamic acid in reducing seroma and hematoma formation following reduction mammaplasty. Aesthetic Surgery Journal. 2022 Jun; 42(6): 616-25. doi: 10.1093/asj/sjab399. DOI: https://doi.org/10.1093/asj/sjab399
Kazzam ME and Ng P. Postoperative Seroma Management. StatPearls. Treasure Island (FL): StatPearls Publishing LLC.; 2023.
Grocott MPW, Murphy M, Roberts I, Sayers R, Toh C-H. Tranexamic acid for safer surgery: the time is now. British Journal of Anaesthesia. 2022 Oct; 129(4): 459–61. doi: 10.1016/j.bja.2022.06.024. DOI: https://doi.org/10.1016/j.bja.2022.06.024
Shah MA, Asghar MI, Siddiqi R, Chaudhri MS, Janjua AM, Iqbal A. Topical application of tranexamic acid reduces postoperative bleeding in open-heart surgery: myth or fact?. Journal of College of Physicians and Surgeons of Pakistan. 2015 Mar; 25(3): 161-5.
Poeran J, Rasul R, Suzuki S, Danninger T, Mazumdar M, Opperer M, et al. Tranexamic acid use and postoperative outcomes in patients undergoing total hip or knee arthroplasty in the United States: retrospective analysis of effectiveness and safety. Bmj. 2014 Aug; 349: 1-10. doi: 10.1136/bmj.g4829. DOI: https://doi.org/10.1136/bmj.g4829
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments
