Tranexamic Acid Prevention of Hemorrhagic Complications Following Interpolated Flap Repair: A Single-Center, Retrospective, Cohort Study

• Published in: Dermatologic surgery Vol. 49; no. 12; pp. 1139 - 1142
• Main Authors: Freeman, S. Caleb, Heath, Michael S., Neill, Brett, Morris, Caroline, Lucero, Olivia M., Yu, Wesley, Bar, Anna, Leitenberger, Justin J.
• Format: Journal Article
• Language: English
• Published: 01-12-2023
• ISSN: 1076-0512; 1524-4725; 1524-4725
• DOI: 10.1097/DSS.0000000000003931

Tranexamic acid (TXA) is increasingly being used to prevent hemorrhagic complications after dermatologic surgery. Interpolated flap repairs following Mohs micrographic surgery are at risk for increased bleeding events and unplanned health care utilization, particularly among patients on antithrombotic medication.BACKGROUNDTranexamic acid (TXA) is increasingly being used to prevent hemorrhagic complications after dermatologic surgery. Interpolated flap repairs following Mohs micrographic surgery are at risk for increased bleeding events and unplanned health care utilization, particularly among patients on antithrombotic medication.To assess bleeding events after interpolated flap repair in patients receiving TXA compared with those who did not.OBJECTIVETo assess bleeding events after interpolated flap repair in patients receiving TXA compared with those who did not.A retrospective review identified interpolated flap repairs in a 5-year period. Hemorrhagic complications were analyzed, defined as major bleeding events, which included all unplanned medical visits, and minor bleeding events, which included any unplanned patient phone calls or messages through electronic medical record.MATERIALS AND METHODSA retrospective review identified interpolated flap repairs in a 5-year period. Hemorrhagic complications were analyzed, defined as major bleeding events, which included all unplanned medical visits, and minor bleeding events, which included any unplanned patient phone calls or messages through electronic medical record.One hundred fifteen patients had interpolated flap repair during the 5-year period, of which 21 (18.3%) received TXA postprocedure. Twenty-seven bleeding events were identified in the non-TXA group compared with 1 event in the TXA-treated group. Patients who received TXA were less likely to have had a bleeding event (28.7% vs 4.8%, p < .01).RESULTSOne hundred fifteen patients had interpolated flap repair during the 5-year period, of which 21 (18.3%) received TXA postprocedure. Twenty-seven bleeding events were identified in the non-TXA group compared with 1 event in the TXA-treated group. Patients who received TXA were less likely to have had a bleeding event (28.7% vs 4.8%, p < .01).Patients undergoing interpolation flap repair were less likely to experience a bleeding event after subcutaneous injection of TXA.CONCLUSIONPatients undergoing interpolation flap repair were less likely to experience a bleeding event after subcutaneous injection of TXA.