The effect of topical application of tranexamic acid on the occurrence of postoperative hematoma after inguinal hernia repair using the Lichtenstein technique

Abstract

Introduction/Objective The objective of the study was to determine whether the local application of tranexamic acid (TXA) by pouring over the surgical wound reduces the incidence of postoperative hematoma and the occurrence of postoperative bleeding in the wound following inguinal hernia repair using the Lichtenstein technique.

Methods We conducted a prospective, randomized, double-blind clinical study in the period from June 2024 to February 2025. One hundred and twenty patients were divided into two groups, one group of patients who received TXA during surgery, and the other group where a placebo was administered. Subsequently, the groups were compared and analyzed by sex and age structure, the frequency of postoperative hematoma, and the pre- and postoperative levels of erythrocytes, hemoglobin, and platelets were recorded.

Results The results indicate that in the group where TXA was administered, postoperative hematoma occurred statistically significantly less often than in the group with a placebo (p < 0.05). The frequency of postoperative hematoma in the group of patients who were treated with TXA was 3.8%, while the frequency in the group of patients who were treated with a placebo was 13%. There was a statistically significant difference in the levels of platelets before and after surgery in the compared groups.

Conclusion We found that the topical application of TXA reduces the occurrence of postoperative hematoma, and thus the occurrence of postoperative bleeding, as well as reduces the postoperative drop in platelets.

Keywords: inguinal hernia repair; tranexamic acid; hematoma; hemoglobin; erythrocytes; platelets