DOI: http://dx.doi.org/10.18203/2349-2902.isj20192949

The effect of intravenous tranexamic acid on reduction of seroma after para- umbilical hernioplasty

Ayman Albatanony, Mahmoud Shahin, Asem Fayed, Ahmed El Shemi

Abstract


Background: Para-umbilical hernioplasty is mostly safe but there are possible complications like seroma, wound infection and recurrence. Tranexamic acid is a synthetic derivative of the amino acid lysine that exerts an anti-fibrinolytic action through the reversible blockade of lysine binding sites on plasminogen molecules, used in the prevention and treatment of excessive bleeding both in primary and secondary care. Our study aimed to evaluate the effect of intravenous tranexamic acid injection on reduction of seroma after para-umbilical hernioplasty.

Methods: We conduct a prospective controlled trial to compare the effect of intra-operative, intravenous single dose of tranexamic acid by a dose of 10 mg/kg body weight with induction of anaesthesia on the occurrence of local wound complications as seroma, wound infection in addition to time of drain removal and the amounts of drain output, by comparison between two groups.

Results: Single intravenous dose of tranexamic acid with induction of anathesia reduced drain duration (P-value was 0.001), drain output in 1st day (P-value was 0.008), and drain output in 5th  day (P-value was 0.036). Adverse effects were not observed.There were no significant difference in occurence of seroma (P-value was 0.429), and wound infection (P-value was 1.00).

Conclusions: Our study revealed that tranexamic acid showed significant correlation with decrease duration of drains and fewer amounts of drain volumes in first day post-operative. 


Keywords


Hernioplasty, Para-umbilical, Seroma, Tranexamic acid

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References


Ammar AA, Ismail T. Abdominal wall hernias in upper Egypt: A different spectrum." East and Central African J Surg. 2008:13(2):109-14.‏

Othman IH, Metwally YH. Comparative study between laparoscopic and open repair of paraumbilical hernia. J Egyptian Society of Parasitol. 2012;42(1):175-82.

Vlasov АV, Kukosh МV. The problem of wound complications in abdominal wall endoprosthesis replacement in ventral hernias. Современные технологии в медицине. 2013;5(2).

Purushotham G, Revanth K, Aishwarya M. Surgical management of umbilical and paraumbilical hernias. Int Surg J. 2017;4(8):2507-11.‏

Halm JA, Heisterkamp J, Veen HF, Weidema WF. Long-term follow-up umbilical hernia repair: are there risk factors for recurrence after simple and mesh repair. Hernia. 2005;9(4):334-7.

Ker K, Edwards P, Perel P, Shakur H, Roberts I. Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis. BMJ. 2012;344.

Ponten JEH, Somers KYA, Nienhuijs SW. Pathogenesis of the epigastric hernia. Hernia. 2012;16(6):627-33.‏

Yan-ping L, Wen-jin Y, Ting-ting Y. Risk factors for postoperative seromas in Chinese breast cancer patients. Chinese Medic J. 2011;124(9): 1300-4.

Patel JN, Spanyer JM, Smith LS. Comparison of intravenous versus topical tranexamic acid in total knee arthroplasty: a prospective randomized study. J Arthroplast. 2014;29(8):1528-31.

Suh DW, Kyung BS, Han SB. Efficacy of tranexamic acid for hemostasis in patients undergoing high tibial osteotomy. J Knee Surg. 2018;31(01):050-5.

Ausen K, Fossmark R, Spigset O. Randomized clinical trial of topical tranexamic acid after reduction mammoplasty. British J Surg. 2015;102(11):1348-53.

Oertli D, Laffer U, Haberthuer F, Kreuter U, Harder F. Perioperative and postoperative tranexamic acid reduces the local wound complication rate after surgery for breast cancer. British J Surg. 1994;81(6):856-9.