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Use of Intraoperative Tranexamic Acid and Wound Complications in Spine Surgery: A Retrospective Cohort Study

Asian Spine Journal 2020년 14권 5호 p.639 ~ 646
Kramer Moti, Drexler Michael, Herman Amir, Kalimian Tal, Klassov Yuri, Nasser Layalee Abu,
소속 상세정보
 ( Kramer Moti ) - Assuta Ashdod University Medical Center Department of Orthopedics
 ( Drexler Michael ) - Assuta Ashdod University Medical Center Department of Orthopedics
 ( Herman Amir ) - Assuta Ashdod University Medical Center Department of Orthopedics
 ( Kalimian Tal ) - Assuta Ashdod University Medical Center Department of Orthopedics
 ( Klassov Yuri ) - Soroka University Medical Center Department of Orthopedics
 ( Nasser Layalee Abu ) - Soroka University Medical Center Department of Orthopedics

Abstract


Study Design: A retrospective cohort study.

Purpose: This study aims to examine the effect of tranexamic acid (TXA) on postoperative wound healing in spine surgery.

Overview of Literature: TXA (Cyklokapron, Hexakapron) is a widely used anti-fibrinolytic drug that is shown to be effective in mitigating hemorrhage during and after surgery by competitively blocking plasminogen in fibrinolytic cascade. Plasminogen also plays a role in inflammatory and infectious diseases. The modulation of this role by TXA may influence the development of postoperative infectious complications.

Methods: We collected and reviewed the charts of 110 patients who underwent spine surgery at our academic center. We used multivariate regression analysis to assess the factors affecting surgical site infection (SSI).

Results: Of the 110 patients included in this study, 21 patients (19%) were categorized as having postoperative wound complications, 16 patients (14%) had deep or superficial wound infection, and five patients (4%) had wound dehiscence. Patients with a higher surgical invasiveness index score, longer surgeries, and older patients were found to be at risk for wound complications. TXA was determined not to be a direct risk factor for wound healing complications and SSIs.

Conclusions: We found no risk of wound healing complications and SSI directly attributable to preoperative and intraoperative treatment with TXA in spine surgeries.

키워드

Tranexamic acid; Spine surgery; Surgical invasiveness index; Plasminogen; Fibrinolysis; Surgical wound dehiscence; Surgical site infection

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