Asian Spine J.  2020 Oct;14(5):639-646. 10.31616/asj.2019.0235.

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

• Kramer M
• Drexler M
• Herman A
• Kalimian T
• Klassov Y
• Nasser LA

• KMID: 2507908
• DOI: http://doi.org/10.31616/asj.2019.0235

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.

Keyword

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