title: Using tranexamic acid soaked absorbable gelatin sponge following complex posterior lumbar spine surgery: A randomized control trial.
abstract: OBJECTIVE
  This paper aims to determine whether the use of Tranexemic Acid (TXA) - soaked absorbable gelatin sponge could more effectively reduce post-operative blood loss and blood transfusion requirements among low-risk adult patients undergoing lumbar spine surgery.
  
  
  METHODS
  A total of 90 consecutive patients undergoing surgery for multilevel posterior lumbar degenerative procedures were prospectively randomized into one of three groups: - TXA Soaked Gelfoam group, absorbable gelatin sponge group or control group. Demographic distribution, total drain output, blood transfusion requirement, length of hospital stay, the number of readmissions, and postoperative complications were analyzed.
  
  
  RESULTS
  In the TXA Soaked Gelfoam, Gelfoam, and control groups, the respective hemovac drainage at the first 8h postoperatively was 81.06±61.21, 166.73±76.76, and 155.67±92.94ml respectively. The second 8h period drainage for the same groups postoperatively was 46.67±40.09, 55.10±43.43, and 82.50±56.67ml and 23.73±25.56, 32.43±25.81 and 44.20±32.44ml for the third 8h period postoperatively. The duration of the post-operative drain left in the TXA Soaked Gelfoam group was significantly shorter than the Gelfoam and control groups (p=0.019 and 0.000, respectively). The TXA Soaked Gelfoam and Gelfoam also had a significantly shorter hospital stay than the control group (p=0.014, and 0.036, respectively). No patient developed adverse reactions attributable to the tranexamic acid soaked absorbable gelatin sponge.
  
  
  CONCLUSIONS
  TXA-soaked absorbable gelatin sponge is a safe, effective treatment for reduction of post-operative blood loss and blood transfusions among low-risk adult patients undergoing lumbar spine surgery.
authors.affiliation: Department of Orthorpaedic Surgery, Peking Union Medical College Hospital, China. Electronic address: string218@126.com.
authors.forename: Jinqian
authors.initials: J
authors.lastname: Liang
authors.affiliation: Department of Spine Union, Hunan Provincial People's Hospital, China. Electronic address: liuhongzhe7890@126.com.
authors.forename: Hongzhe
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Spine Union, Hunan Provincial People's Hospital, China. Electronic address: huangxiangwang@126.com.
authors.forename: Xiangwang
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Spine Union, Hunan Provincial People's Hospital, China. Electronic address: xiongwei@126.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Xiong
authors.affiliation: Department of Orthorpaedic Surgery, Peking Union Medical College Hospital, China. Electronic address: zhaohongpumch@126.com.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Department of Orthorpaedic Surgery, Changi General Hospital, Singapore.
authors.forename: Sooyong
authors.initials: S
authors.lastname: Chua
authors.affiliation: Department of Orthorpaedic Surgery, Peking Union Medical College Hospital, China. Electronic address: Lizheng1984@126.com.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000933:Antifibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use*; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D013123:Spinal Fusion / Q000379:methods*; D014148:Tranexamic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
keywords: Absorbable gelatin sponge; Posterior lumbar fusion; Prospective study; TXA