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1. Bleeding reduction after topical application of tranexamic acid together with Betadine solution in total knee arthroplasty. A randomised controlled study

Author

M.L.A. Tavares de Souza, Lúcio Honório de Carvalho, M.J. Gonçalves, L. Paiva Costa, L.F. Machado Soares, and E. Frois Temponi

Subjects
Male, Tranexamic acid, medicine.medical_specialty, Administration, Topical, Povidone-iodine solution, Total knee arthroplasty, Betadine Solution, Postoperative Hemorrhage, Knee Joint, Group B, law.invention, Randomized controlled trial, Blood loss, law, medicine, Humans, Orthopedics and Sports Medicine, Prospective Studies, Arthroplasty, Replacement, Knee, Povidone-Iodine, Aged, Dose-Response Relationship, Drug, business.industry, Antifibrinolytic Agents, Surgery, Anesthesia, Anti-Infective Agents, Local, Drug Therapy, Combination, Female, Complication, business, Follow-Up Studies, medicine.drug
Abstract

Introduction Topical application of tranexamic acid to the knee joint before closure in total knee arthroplasty reduces postoperative bleeding without increase in complication. However, it is unknown the effectiveness of topic TXA performed with other topical medications, like povidone-iodine solution. Materials and methods One hundred and twenty-five patients were randomized to receive 100 mL of povidone-iodine solution (control: group A) or 1.5 (group B) and 3.0 g (group C) of topical TXA in povidone-iodine solution applied into the knee before closure in total knee arthroplasty. Results The patients in the TXA groups had higher mean postoperative hemoglobin levels ( P = 0.01 and P = 0.03 in groups B and C, respectively) and a reduced postoperative blood loss in the TXA groups ( P = 0.07 and P = 0.09 in groups B and C, respectively). No significant complications were observed. Discussion In this study, topical application of tranexamic acid after total knee arthroplasty together with povidone-iodine solution results in higher postoperative hemoglobin levels and lower blood loss compared with those in the control group without other complications. Level of evidence I – I: high-powered prospective randomized trial.

Published
2015
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2. Effectiveness of Chitosan Films Impregnated With Ciprofloxacin for the Prophylaxis of Osteomyelitis in Open Fractures: An Experimental Study in Rats.

Author

Paiva Costa L, Moreira Teixeira LE, Maranhão Lima GS, Mendes Ferreira M, de Andrade MA, Teixeira Vidigal PV, Gomes Faraco AA, Temponi EF, and de Araújo ID

Abstract

Background: The systemic antimicrobial prophylaxis is the standard treatment in the prevention of osteomyelitis after open fractures, with topical application of antimicrobials as an alternative due to their high concentrations at the site of the fracture, low systemic concentrations and fewer side effects., Objectives: This study aimed to evaluate the effectiveness of prophylaxis of osteomyelitis through experimental model of open fractures with the use of chitosan films, whether or not impregnated with ciprofloxacin., Materials and Methods: In this experimental study, 24 Holtzman rats were distributed into 4 groups of 6 rats each. The CT (control of treatment) group: an open fracture model treated with systemic antimicrobial; the IC (infection control) group: an open fracture untreated model; the C (chitosan) group: an open fracture model treated using a chitosan film; and the CA (chitosan with antimicrobial) group: an open fracture model treated using a chitosan film impregnated with antimicrobial. After 3 weeks the animals were killed by an overdose of anesthetic, and a fragment osseous was removed for histological and microbiological analysis. The comparisons between the groups considered significant values of P ≤ 0.05., Results: In cultures of the CT group, there was less bacterial growth compared to the results of the cultures of the IC (P = 0.005), C (P = 0.005) and CA (P = 0.009) groups. The inflammation was lower in the CT group compared to the IC (P = 0.014), C (P = 0.001) and CA (P = 0.007) groups., Conclusions: In this experimental model of open fracture, the chitosan film pure or impregnated with ciprofloxacin was not effective in the prophylaxis of osteomyelitis.

Published
2016
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