Serum Concentrations and Pharmacokinetics of Tranexamic Acid after Two Means of Topical Administration in Massive Weight Loss Skin-Reducing Surgery

What is it about?

Tranexamic acid is an old drug widely used to prevent bleeding in surgery. Although regarded very safe, it is administered mainly to patients undergoing surgery with a significant risk of bleeding. Uncertainties regarding possible side effects when administered intravenously prevents widespread use of this inexpensive drug. Studies are emerging which prove that administering the drug locally onto the surgical wound may prevent bleeding just as well as intravenous administration, with an assumed associated lessened risk of adverse effects in the rest of the body. To what extent locally applied drug is actually absorbed into the blood has so far not been properly explored. In this study, we followed patients undergoing skin reducing surgery after massive weight loss. These patients received tranexamic acid onto their large wound surfaces in two different ways: Either by moistening the surface prior to wound closure with a rather high concentration of drug (20 ml of 25 mg/ml tranexamic acid), og instilling a bolus of 200 ml 5% tranexamic acid into the wound cavity after closure. We then followed the serum concentration by taking blood samples for regular intervals for 24 hours. Maximum concentration in the blood did not reach the lowest level known for possible effect on the body, and hence this means of local administration should pose very little danger of adverse effects in the patient and can be recommended for general use.

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