PDF(Pubmed)
Abstract：
UNASSIGNED: Tranexamic acid (TXA) use has become common in orthopedic surgeries. Despite the growing number of publications related to its use, no recent systematic reviews have been published examining TXA use in foot and ankle surgery. The purpose of this review article is to provide a summary of the current available literature regarding TXA use in foot and ankle surgery and to further the understanding of its safety and efficacy.
UNASSIGNED: This systematic review utilized PubMed, Ovid, CINAHL, Clinical Key, Medline, and Embase, and the search was conducted through December 22, 2022. Key words used in the search included: \"tranexamic acid,\" \"TXA,\" \"foot,\" \"ankle,\" \"calcaneal,\" and \"surgery.\" The outcomes within the studies analyzed included measures of perioperative blood loss (intra-operative blood loss, 24-hour post-operative blood loss, blood loss from hour 24 to hour 48, post-operative hemoglobin (Hgb), and post-operative hematocrit [Hct]), as well as wound complications and vascular events. Meta-regression was included to assess the impact of age on between-study variation.
UNASSIGNED: Ten studies met preliminary inclusion criteria. Upon further inspection, eight met full inclusion criteria for the meta-analysis. Despite a growing amount of literature on the topic, there is still a paucity of literature published on TXA use in foot and ankle surgery. Current literature suggests that foot and ankle surgery patients treated with TXA may have reduced 24-hour post-operative blood loss (MD=-183.41 mL, 95% CI=-247.49 to -119.34 mL, p<0.001), increased post-operative hemoglobin (MD=0.71 g/dL, 95% CI=0.11 to 1.31 g/dL, p=0.020) and hematocrit (MD=2.66%, 95% CI=0.07 to 5.24%, p=0.040) when compared to similar patients not receiving TXA. The use of TXA in foot and ankle surgery did not lead to increased thromboembolic complications. Meta-regression indicated no clinically relevant association of age to between-study variation.
UNASSIGNED: TXA was found to be a safe treatment that did affect wound healing or infection rates while decreasing perioperative blood loss. Further research should be performed to evaluate the long-term effects of TXA administration on patient outcomes after foot and ankle surgery.
UNASSIGNED: This systematic review utilized PubMed, Ovid, CINAHL, Clinical Key, Medline, and Embase, and the search was conducted through December 22, 2022. Key words used in the search included: \"tranexamic acid,\" \"TXA,\" \"foot,\" \"ankle,\" \"calcaneal,\" and \"surgery.\" The outcomes within the studies analyzed included measures of perioperative blood loss (intra-operative blood loss, 24-hour post-operative blood loss, blood loss from hour 24 to hour 48, post-operative hemoglobin (Hgb), and post-operative hematocrit [Hct]), as well as wound complications and vascular events. Meta-regression was included to assess the impact of age on between-study variation.
UNASSIGNED: Ten studies met preliminary inclusion criteria. Upon further inspection, eight met full inclusion criteria for the meta-analysis. Despite a growing amount of literature on the topic, there is still a paucity of literature published on TXA use in foot and ankle surgery. Current literature suggests that foot and ankle surgery patients treated with TXA may have reduced 24-hour post-operative blood loss (MD=-183.41 mL, 95% CI=-247.49 to -119.34 mL, p<0.001), increased post-operative hemoglobin (MD=0.71 g/dL, 95% CI=0.11 to 1.31 g/dL, p=0.020) and hematocrit (MD=2.66%, 95% CI=0.07 to 5.24%, p=0.040) when compared to similar patients not receiving TXA. The use of TXA in foot and ankle surgery did not lead to increased thromboembolic complications. Meta-regression indicated no clinically relevant association of age to between-study variation.
UNASSIGNED: TXA was found to be a safe treatment that did affect wound healing or infection rates while decreasing perioperative blood loss. Further research should be performed to evaluate the long-term effects of TXA administration on patient outcomes after foot and ankle surgery.
摘要：
■在骨科手术中使用氨甲环酸（TXA）已变得很普遍。尽管与它的使用有关的出版物越来越多，近期尚未发表关于TXA在足踝手术中应用的系统评价.本文的目的是提供有关TXA在足踝手术中使用的现有文献的摘要，并进一步了解其安全性和有效性。
■本系统综述利用PubMed，奥维德,CINAHL,临床关键,Medline,和Embase,搜索进行到2022年12月22日。搜索中使用的关键词包括：“氨甲环酸，\"\"TXA,\"\"脚,\"\"脚踝,\"\"跟骨,“和”手术。“分析的研究结果包括围手术期失血的测量(术中失血，术后24小时失血,24小时至48小时失血，术后血红蛋白（Hgb），和术后血细胞比容[Hct])，以及伤口并发症和血管事件。纳入Meta回归以评估年龄对研究间变异的影响。
■10项研究符合初步纳入标准。经进一步检查,8人符合meta分析的完全纳入标准.尽管关于这个话题的文献越来越多，关于TXA在足踝手术中的应用的文献仍然很少。目前的文献表明，接受TXA治疗的足踝手术患者术后24小时失血量可能减少（MD=-183.41mL，95%CI=-247.49至-119.34mL，p<0.001)，术后血红蛋白增加（MD=0.71g/dL，95%CI=0.11至1.31g/dL，p=0.020)和血细胞比容(MD=2.66%，95%CI=0.07至5.24%，与未接受TXA的类似患者相比，p=0.040）。在足踝手术中使用TXA不会导致血栓栓塞并发症的增加。荟萃回归表明年龄与研究之间的差异没有临床相关的关联。
■TXA被发现是一种安全的治疗方法，可以影响伤口愈合或感染率，同时减少围手术期失血量。应进行进一步的研究以评估TXA给药对足踝手术后患者预后的长期影响。
■本系统综述利用PubMed，奥维德,CINAHL,临床关键,Medline,和Embase,搜索进行到2022年12月22日。搜索中使用的关键词包括：“氨甲环酸，\"\"TXA,\"\"脚,\"\"脚踝,\"\"跟骨,“和”手术。“分析的研究结果包括围手术期失血的测量(术中失血，术后24小时失血,24小时至48小时失血，术后血红蛋白（Hgb），和术后血细胞比容[Hct])，以及伤口并发症和血管事件。纳入Meta回归以评估年龄对研究间变异的影响。
■10项研究符合初步纳入标准。经进一步检查,8人符合meta分析的完全纳入标准.尽管关于这个话题的文献越来越多，关于TXA在足踝手术中的应用的文献仍然很少。目前的文献表明，接受TXA治疗的足踝手术患者术后24小时失血量可能减少（MD=-183.41mL，95%CI=-247.49至-119.34mL，p<0.001)，术后血红蛋白增加（MD=0.71g/dL，95%CI=0.11至1.31g/dL，p=0.020)和血细胞比容(MD=2.66%，95%CI=0.07至5.24%，与未接受TXA的类似患者相比，p=0.040）。在足踝手术中使用TXA不会导致血栓栓塞并发症的增加。荟萃回归表明年龄与研究之间的差异没有临床相关的关联。
■TXA被发现是一种安全的治疗方法，可以影响伤口愈合或感染率，同时减少围手术期失血量。应进行进一步的研究以评估TXA给药对足踝手术后患者预后的长期影响。
