Compared to conventional dressing techniques, tranexamic acid injection provide better surgical outcomes in spinal fusion surgery

The use of mechanical and chemical hemostatic control techniques in spinal fusion surgery is common in Indonesia. However, there has been no study comparing the two in a single clinical trials. This study aims to find out which best of tranexamic acid injection, a bulky compression dressing and a standard dressing in providing surgical outcomes in spinal fusion surgery. Thirty patients were grouped into three, 10 patients each. To Group 1, tranexamic acid at a dose of 500 mg/ml was administered pre operation and 2 hours later. For Group 2, a bulky compression dressing was performed by covering the surgical wounds with a low-adherent dressing, overlaid with four layers of sterile gauze and then sealed with a conformable adhesive retention tape. Standard dressing was applied to the patients of Group-3 using the same type of bandage and adhesive tape given to the Group-2, but only overlaid with two layers of sterile gauze. There is no statistical difference among trials groups for preoperative (P > 0.220) and postoperative (P > 0.380) hemoglobin levels and the level of perioperative blood loss (P > 0.110). With respect to number of transfusion required, the tranexamic acid group was significantly lower compared to the standard dressing group (P = 0.018). No abnormality of wound seen in all three trials groups and only 2 patients of bulky compression dressing group reported experience of headache. In conclusion, tranexamic acid is better to promote hemostasis compared to conventional dressing techniques.