Poster 357: Tranexamic Acid in Foot and Ankle Surgery: A Systematic Review and Meta-analysis

Objectives: 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 foot and ankle surgery. The aim this review article is provide a summary current available literature regarding surgery further understanding safety efficacy. Methods: This was following 2020 Preferred Reporting Items for Systematic Reviews Meta-Analyses (PRISMA) guidelines as outlined on PRISMA checklist. Databases utilized included PubMed, Ovid, CINAHL, Clinical Key, Medline, Embase, search conducted through May 21, 2022. Key words used included: “tranexamic acid,” “TXA,” “foot,” “ankle,” “calcaneal,” “surgery.” outcomes within studies analyzed measures perioperative blood loss (intra-operative loss, 24-hour postoperative from hour 24 48, hemoglobin (Hgb), hematocrit (Hct)), well wound complications vascular events. Wound events were defined infection, hematoma formation, necrosis, dehiscence, DVT, PE, myocardial infarction (MI), acute coronary syndrome (ACS), cardiovascular event (CVA), limb ischemia (LI), gastrointestinal hemorrhage (GIH), nerve damage, any other conditions specified or individual studies. Cochrane Collaboration’s Risk Bias 2 (RoB2) tool assess risk bias included. quality scored using modified Coleman methodology score (MCMS). Primary treatment having data three more summarized forest plots RevMan 5.4.1 software (The Collaboration, Copenhagen, Denmark). Random-Effects models calculate mean differences with 95% confidence intervals each outcome measure. Heterogeneity assessed Tau , Chi I statistics. Statistical significance set at α=0.05 all comparisons. Results: produced 1125 papers. full texts 16 inclusion exclusion criteria seven met preliminary criteria. Upon inspection, five meta-analysis. All groups receiving had statistically significantly lower values hours. One study found significant increase 24-48 hours their A group versus non-TXA. Three demonstrated higher patients not TXA. No between non-TXA groups. Conclusions: amount topic, there still paucity Additional required determine best strategy optimize patient outcomes. Current suggests that treated may reduced increased when compared similar did lead thromboembolic complications.