Topical application of tranexamic acid in anticoagulated patients undergoing minor oral surgery: A systematic review and meta-analysis of randomized clinical trials

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• 作者：Sara Juliana de Abreu de Vasconcellos ; Thiago de Santana Santos ; Daniele Machado Reinheimer ; André ; Luis Faria-e-Silva ; Maria de Fá ; tima Batista de Melo ; Paulo Ricardo Saquete Martins-Filho ; ^{martins-filho@ufs.br}
• 关键词：Evidence-based dentistry ; Hemorrhage ; Oral surgical procedures ; Tranexamic acid
• 刊名：Journal of Cranio-Maxillofacial Surgery
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：45
• 期：1
• 页码：20-26
• 全文大小：940 K
• 卷排序：45

文摘

To perform a systematic review and meta-analysis of randomized clinical trials (RCTs) investigating the efficacy and safety of topical tranexamic acid (TXA) to prevent postoperative bleeding in anticoagulated patients undergoing minor oral surgery.Material and methodsWe analyzed RCTs comparing the use of topical TXA versus other topical hemostatic agents or placebo solutions for minor oral surgeries. We assessed the risk of bias and strength of evidence according to the Cochrane guidelines and GRADE rating system, respectively. The pooled relative risk (RR) was calculated for the effect of topical application of TXA on postsurgical bleeding.ResultsFive RCTs were included in the study. The combined RR for the number of patients receiving TXA in comparison to the control group was 0.13 (95% CI 0.05–0.36; P = 0.01), indicating a protective effect of topical TXA on bleeding after minor oral surgeries. Subgroup analysis revealed that topical TXA was effective in preventing postsurgical bleeding compared to placebo and epsilon-aminocaproic acid. No cases of thromboembolic events were reported.ConclusionsCurrently available evidence suggests that surgical site irrigation with TXA followed by mouthwash during the first postoperative week is safe and may reduce the risk of bleeding after minor oral surgeries in anticoagulated patients.