Compared to Conventional Dressing Techniques, Tranexamic Acid Injection Provide Better Surgical Outcomes in Spinal Fusion Surgery
Ahmad Fauzi1, Adam Moelyono2  and S Dohar Tobing3

1Orthopaedic-Spine Consultant, Faculty of Medicine, University of Lampung, Bandar Lampung, Indonesia.

2Orthopaedic-Spine Consultant, Faculty of Medicine, Gajah Mada University, Yogyakarta, Indonesia.

3Orthopaedic-Spine Consultant, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.

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Abstract: The use of mechanical and chemical hemostatic control techniques in spinal fusion surgery is common in Indonesia. However, there has been no study comparing the two in a single clinical trials. This study aims to find out which best of tranexamic acid injection,  a bulky compression dressing and a standard dressing in providing surgical outcomes in spinal fusion surgery. Thirty patients were grouped into three, 10 patients  each. To Group 1, tranexamic acid at a dose of 500 mg/ml was administered pre operation and 2 hours later. For Group 2, a bulky compression dressing was performed by covering the surgical wounds with a low-adherent dressing, overlaid with  four layers of sterile gauze and then sealed with a conformable adhesive retention tape. Standard dressing was applied to the patients of Group-3 using the same type of bandage and adhesive tape given to the Group-2, but only overlaid with two layers of sterile gauze. There is no statistical difference among trials groups for preoperative (P > 0.220) and postoperative (P > 0.380) hemoglobin levels and the level of perioperative blood loss (P > 0.110). With respect to number of transfusion required, the tranexamic acid group was significantly lower compared to the standard dressing group (P = 0.018). No abnormality of wound seen in all three trials groups and only 2 patients of bulky compression dressing group reported experience of headache. In conclusion, tranexamic acid is better to promote hemostasis compared to conventional dressing techniques.

Keywords: Compression Dressing; Spine Surgery; Surgical Outcomes; Tranexamic Acid

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