TXA in combat casualty care-does it adversely affect extremity reconstruction and flap thrombosis rates?

Military Medicine

Volumn 180, Issue 3, 2015, Pages 24-28

  Valerio, Ian L ^a   Campbell, Paul ^a   Sabino, Jennifer ^a   Lucas, Donald J ^a   Jessie, Elliot ^a   Rodriguez, Carlos ^a   Fleming, Mark ^a  

^a WALTER REED ARMY MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIFIBRINOLYTIC AGENT; TRANEXAMIC ACID;

ADULT; ARM INJURIES; FEMALE; FOLLOW UP; FREE TISSUE GRAFT; HUMAN; INCIDENCE; INJURY SCALE; LEG INJURIES; MALE; MASS DISASTER; MIDDLE AGED; POSTOPERATIVE COMPLICATIONS; PROCEDURES; RECONSTRUCTIVE SURGERY; RETROSPECTIVE STUDY; RISK FACTOR; SOFT TISSUE INJURIES; THROMBOSIS; UNITED STATES; VASCULARIZATION; WAR; YOUNG ADULT;

ADULT; ANTIFIBRINOLYTIC AGENTS; ARM INJURIES; FEMALE; FOLLOW-UP STUDIES; FREE TISSUE FLAPS; HUMANS; INCIDENCE; INJURY SEVERITY SCORE; IRAQ WAR, 2003-2011; LEG INJURIES; MALE; MASS CASUALTY INCIDENTS; MIDDLE AGED; POSTOPERATIVE COMPLICATIONS; RECONSTRUCTIVE SURGICAL PROCEDURES; RETROSPECTIVE STUDIES; RISK FACTORS; SOFT TISSUE INJURIES; THROMBOSIS; TRANEXAMIC ACID; UNITED STATES; YOUNG ADULT;

EID: 84943567311     PISSN: 00264075     EISSN: 1930613X     Source Type: Journal    
DOI: 10.7205/MILMED-D-14-00479     Document Type: Article

References (17)

1. Kotwal RS, Montgomery HR, Kotwal BM, et al: Eliminating preventable death on the battlefield. Arch Surg 2011; 146(12): 1350–8.
2. Gillern SM, Sheppard FR, Evans KN, et al: Incidence of pulmonary embolus in combat casualties with extremity amputations and fractures. J Trauma 2011; 71(3): 607–12.
3. Borgman MA, Spinella PC, Perkins JG, et al: The ratio of blood products transfused affects mortality in patients receiving massive transfusions at combat support hospital. J Trauma 2007; 63(4): 805–13.
4. Eastridge BJ, Mabry RL, Sequin P, et al: Death on the battlefield (2001– 2011): implications for the future of combat casualty care. J Trauma Acute Care Surg 2012; 73(6 Suppl 5): S431–7.
5. Morrison JJ, Dubose JJ, Rasmussen TE, Midwinter MJ: Military application of tranexamic acid in trauma emergency resuscitation (MATTERs) study. Arch Surg 2012; 147(2): 113–9.
6. Shakur H, Roberts I, Bautista R, et al: Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomized, placebocontrolled trial. Lancet 2010; 376(9734): 23–32.
7. Committee on Tactical Combat Casualty Care: Tranexamic Acid (TXA) in Tactical Combat Casualty Care Guideline Revision Recommendation, August 11, 2011. Available at http://www.docs-archive.com/view/ 258cca1d4446ee1a538580d9afcb24d9/Fluid-Resuscitation-in-Tactical- Evacuation-Care.pdf; accessed July 17, 2014.
8. Knudson MM, Gomez D, Haas B, Cohen MJ, Nathens AB: Three thousand seven hundred thirty-eight posttraumatic pulmonary emboli: a new look at an old disease. Ann Surg 2011; 254(4): 625–32.
9. Pearson S, Peterson P, Nguyen B: Incidence of pulmonary embolus and rate of nondiagnostic CTs PE/DVT studies in soldiers with polytrauma. Chest 2010; 138(4): 879A.
10. Valerio I, Sabino J, Heckert R, et al: Known preoperative deep venous thrombosis and/or pulmonary embolus: to flap or not to flap the severely injured extremity? Plast Reconstr Surg 2013; 132(1): 213–20.
11. Gifford SM, Aidinian G, Clouse WD, et al: Effect of temporary shunting on extremity vascular injury: an outcome analysis from the Global War on Terror vascular injury initiative. J Vasc Surg 2009; 50(3): 549–55.
12. Pfizer: Cyklokapron (tranexamic acid) injection package insert. 2008. Available at www.pfizer.com/products/rx/prescription.jsp; accessed July 10, 2014.
13. European Medicines Agency: Antifibrinolytics containing aprotinin, aminocaproic acid and tranexamic acid aprotinin. Assessment Report, September 2013. Available at http://www.ema.europa.eu/docs/en_GB/document_library/Referrals_document/Antifibrinolytic_medicines/ WC500153601.pdf; accessed August 22, 2014.
14. Jimenz JJ, Iribarren JL, Lorente L, et al: Tranexamic acid attenuates inflammatory response in cardiopulmonary bypass surgery through blockade of fibrinolysis: a case control study followed by a randomized double-blind controlled trial. Crit Care 2007; 11(6): R117.
15. Menger MD, Laschke MW, Amon M, et al: Experimental models to study microcirculatory dysfunction in muscle ischemia–reperfusion and osteomyocutaneous flap transfer. Langenbecks Arch Surg 2003; 388(5): 281–90.
16. Widgerow AD: Ischemia-reperfusion injury: influencing the microcirculatory and cellular environment. Ann Plast Surg 2014; 72(2): 253–60.
17. Khouri RK, Cooley BC, Kenna DM, Edstrom LE: Thrombosis of microvascular anastomoses in traumatized vessels: fibrin versus platelets. Plast Reconstr Surg 1990; 86(1): 110–7.