• Guadalupe Castillo-Cardiel, Marisol Avalos-López, Carlos Méndez-Miranda, Javier Alejandro Gil-Vigna, Clotilde Fuentes-Orozco, Gabino Cervantes-Guevara, Enrique Cervantes-Pérez, Sol Ramírez-Ochoa, Andrea Socorro Álvarez-Villaseñor, Ana Olivia Cortés-Flores, Kathia Dayana Morfín-Meza, Andrea García, Sergio Jiram Vázquez-Sánchez, and Alejandro González-Ojeda.
• Department of Maxillofacial Plastic and Reconstructive Surgery, Specialties Hospital, Western Medical Center, Mexican Institute of Social Security and Universidad de Guadalajara. Guadalajara, Jalisco, Mexico.
• Burns. 2024 Nov 30; 51 (2): 107339107339.

IntroductionBurns are traumatic events that can affect multiple systems beyond the skin. The rapid removal of the burn eschar is a key step in the effective treatment of severe burns, and surgical debridement is currently the standard of care for eschar removal in burn patients. However, surgical debridement is highly hemorrhagic. Tranexamic acid, an antifibrinolytic lysine analog, may reduce bleeding.MethodsA randomized control trial was conducted to examine the effects of preoperative tranexamic acid administration in the early surgical debridement of severe burns. The study was conducted from January to December 2022.ResultsThe general characteristics of patients and mechanism of injury were similar between the treated and control groups. The burned body surface area was 26.46 % ± 5.45 % in the study group and 27.10 % ± 4.45 % in the control group (p = 0.83). Intraoperative hemorrhage volume was larger in the control group (299.3 ± 88.9 ml) than in the study group (117 ± 51.7 ml) (p = 0.0001). The decreases in hemoglobin and hematocrit levels were larger in the control group (2.1 ± 1.4 g/dl and 5.7 % ± 4.6 %) than in the study group (0.85 ± 0.4 g/dl and 2.1 % ± 0.5 %) (p = 0.004 and 0.01, respectively). Six patients in the control group but no patients in the study group required blood transfusion (p = 0.002). No thromboembolic events were observed.ConclusionThese findings suggest that tranexamic acid was effective at reducing intraoperative hemorrhage volume and the need for transfusion in burn surgery patients. It was shown to be safe for use in these patients.Copyright © 2024 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.

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