Tranexamic Acid in Mohs Micrographic Surgery: A Systematic Review

Abstract

BACKGROUND Tranexamic acid (TXA) is an antifibrinolytic that has historically been used to treat menorrhagia and bleeding disorders. Exploration of its use in procedures has grown, and it has shown promise in its ability to achieve hemostasis with low risk to patients. Analysis of its use in Mohs micrographic surgery (MMS) is warranted due to its potential superiority to traditional methods of achieving hemostasis (direct pressure, electrocoagulation, and sutures). OBJECTIVE To perform a systematic review of studies which evaluate the efficacy and safety profile of topical application or subcutaneous injection of TXA and analyze as it applies to MMS. MATERIALS AND METHODS A comprehensive literature search was conducted using the PubMed database to identify relevant studies using the search terms: “tranexamic acid” OR “TXA.” The search was performed up to December 1, 2023. RESULTS Tranexamic acid has a strong safety profile, and its effectiveness in achieving hemostasis is well-demonstrated. Tranexamic acid has reduced risk of bleeding complications compared with traditional methods of achieving hemostasis. CONCLUSION An extensive review of the literature has yielded positive results, suggesting the potential of TXA in improving patient outcomes, reducing surgical time, decreasing intraoperative and postoperative bleeding, and increasing overall patient satisfaction.