Effects of Local Administration of Tranexamic Acid on Reducing Postoperative Blood Loss in Surgeries for Closed, Sanders III–IV Calcaneal Fractures: A Randomized Controlled Study

Abstract

Purpose To investigate whether local administration of tranexamic acid (TXA) is effective in postoperative blood loss reduction in surgeries for Sanders III–IV calcaneal fractures. Methods Calcaneal fracture patients who were hospitalized in our hospital from August 2014 to April 2018 and underwent open reduction internal fixation (ORIF) via lateral approach with an L-shaped incision were included in the present study. 53 Patients were randomly divided into three groups, groups A (17), B (17) and C (19). Twenty milliliters of 10 mg/ml and 20 mg/ml TXA solution were perfused into the incision of patients in group A and group B, respectively. Twenty milliliters of saline were perfused into the incision of patients in group C as control. The volume of postoperative drainage, postoperative blood test, coagulation test, and wound complications were analyzed to evaluate the effectiveness of local administration of TXA on blood loss reduction. Results The amount of drainage at 24 and 48 h after the procedure was 110\u2009±\u2009170, 30\u2009±\u200910 ml and 130\u2009±\u2009160, 20\u2009±\u200917 ml for patients in group A and group B, respectively. The corresponding numbers for patients in group C were 360\u2009±\u2009320, 20\u2009±\u200910 ml. The difference between group A and group C was statistically significant, so was the difference between group B and group C. No statistically significant difference was found between group A and group B. Postoperative blood test results revealed that the levels of hemoglobin and hematocrit were significantly higher in group A and group B when each compared to that of group C. In contrast, no difference was found between group A and group B. No significant difference was found between each experimental group and the control group in terms of platelet counts, prothrombin time (P.T.), activated partial prothrombin time (APTT), and wound complications. Conclusion Local administration of TXA is effective in the reduction of postoperative blood loss in surgeries for Sanders III–IV types of calcaneal fractures without notably associated side effects.