Comparative efficacy of tranexamic acid versus placebo on hemostatic outcomes after the surgical debridement of burn patients: A randomized controlled clinical trial

Introduction: Burns 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. Methods: A 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. Results: The general characteristics of patients and mechanism of injury were similar between the treated and control groups. The burned body surface area was 26.46 % f 5.45 % in the study group and 27.10 % f 4.45 % in the control group (p = 0.83). Intraoperative hemorrhage volume was larger in the control group (299.3 f 88.9 ml) than in the study group (117 f 51.7 ml) (p = 0.0001). The decreases in hemoglobin and hematocrit levels were larger in the control group (2.1 f 1.4 g/dl and 5.7 % f 4.6 %) than in the study group (0.85 f 0.4 g/dl and 2.1 % f 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. Conclusion: These 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.