title: Topical Hemostatic-Anesthetic Solution to Reduce Bleeding During Mohs Micrographic Surgery: A Case Control Study.
abstract: BACKGROUND
  Between stages of Mohs micrographic surgery, the wound is dressed and the patient waits for the histopathological results.<br/>
  
  
  OBJECTIVE
  To investigate the efficacy of a hemostatic-anesthetic solution-impregnated gauze in decreasing bleeding between Mohs stages.<br/>
  
  
  METHODS
  Twenty patients were treated with a hemostatic-anesthetic solution composed of tranexamic acid, adrenaline, and lidocaine (TAL), and 20 others were treated with a saline solution for control. At the second Mohs stage, size measurements of the blood stain on a Telfa pad and the defect were recorded. The Rotation Thromboelastometry Method (ROTEM) was used to investigate a possible effect of lidocaine and adrenaline on the clot stability induced by tranexamic acid.<br/>
  
  
  RESULTS
  The ratio of blood stain size to Mohs defect size in the hemostatic anesthetic solution group was 1:1.47, whereas the ratio in the control saline group was 1:3.37 (P&lt;.001). Results of the ROTEM test showed that lidocaine and adrenaline did not interfere with the effect of tranexamic acid on clot formation and stability.<br/>
  
  
  CONCLUSIONS
  The application of gauze impregnated with tranexamic acid, adrenaline, and lidocaine on a surgical wound may be effective in reducing bleeding between Mohs stages. <br /><br /> <em>J Drugs Dermatol.</em> 2016;15(7):851-855.
authors.forename: Isaac
authors.initials: I
authors.lastname: Zilinsky
authors.forename: Tamar Brutman
authors.initials: TB
authors.lastname: Barazani
authors.forename: Boris
authors.initials: B
authors.lastname: Shenkman
authors.forename: Oren
authors.initials: O
authors.lastname: Weisman
authors.forename: Nimrod
authors.initials: N
authors.lastname: Farber
authors.forename: Uriel
authors.initials: U
authors.lastname: Martinowitz
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D016022:Case-Control Studies; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D007431:Intraoperative Complications / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery / Q000009:adverse effects* / Q000379:methods; D019999:Pharmaceutical Solutions / Q000008:administration & dosage
chemical_list: D000779:Anesthetics, Local; D006490:Hemostatics; D019999:Pharmaceutical Solutions