Clinical Trial: Prevention of Intraoperative Bleeding and Postoperative Swelling in Orthognathic Surgery Through the Use of Tranexamic Acid
Study Status: Completed
Recruit Status: Completed
Study Type: Interventional
Official Title: Prevention of Bleeding and Edema in Bimaxillary Orthognathic Surgery; the Effectiveness of Tranexamic Acid on Intraoperative Bleeding and Postoperative Swelling in Orthogn
Brief Summary:
Purpose of the study:
- To evaluate the effect of tranexamic acid (TXA) of intraoperative blood loss in patients subjected to bi-maxillary orthognathic surgery
- To evaluate the potential effect of TXA on fibrin structure
- To evaluate the potential effect of TXA of binding of plasminogen to fibrin
- To evaluate the potential effect of TXA on postoperative edema formation.
Hypothesis:
H0: Intraoperative bleeding cannot be significantly reduced by preoperative administration of tranexamic acid
H0,1: Postoperative edema cannot be significantly reduced by preoperative administration of tranexamic acid
Detailed Summary:
The study population consists of patients referred to simultaneous mandibular and maxillary osteotomy at the Department of Oral and Maxillofacial Surgery, Hospital of South West Denmark in 2014.
Hundred patients (50 men and 50 women) will be enrolled in the study. Reportedly, the mean intraoperative blood loss in the placebo group is expected to be 436 ml with a standard deviation of 208 ml. The difference in blood loss between the TXA-group and the placebo group to be detected is 100 ml. The dropout frequency is estimated to 10%. To fulfil these assumptions a minimum of 40 patients should be included in each group to reach a power of 0.8 and an alpha of 0.05. In order to accommodate an even gender distribution a block randomization is performed resulting in the randomization of 100 patients.
The patients will be randomized to receive blindly either 10 ml tranexamic acid (100 mg/ml) (Pfizer, Ballerup, Denmark) or 10 ml saline (9mg/ml) preoperatively. Intraoperative blood loss will be determined by deducting the total volume of irrigation fluids from the volume of the contents of the surgical suction device. Postoperative edema formation will be determined by 3D surface scanning and volumetric analysis will be carried out in the "Landmarker" software.
Sponsor: Hospital of South West Denmark
Current Primary Outcome: Intra-operative bleeding volume (ml) [ Time Frame: Within 10 minutes after ended surgery ]
Original Primary Outcome: Same as current
Current Secondary Outcome:
- Change in hemostatic profile [ Time Frame: Baseline, 5.5 hours, 48 hours and 4 months postoperatively ]Changes in the hemostatic profile measured through thrombelastography, thrombin generation test and fibrin structure analysis.
- Change in inflammatory profile [ Time Frame: Baseline, 5.5 hours, 48 hours and 4 months postoperatively ]Changes in the inflammatory profile are investigated through measures of surface induced activation, inflammation and plasminogen binding.
- Postoperative edema formation [ Time Frame: 48 hours and 4 months postoperatively ]The degree of postoperative swelling in connection with TXA /or not, is determined by non-invasive 3D face scans and quantified using the "Landmarker" software. Scans are carried out along with the 3rd and 4th blood samples, 48 hours and 4 months postoperatively.
Original Secondary Outcome:
- Change in hemostatic profile [ Time Frame: Baseline and 5.5 hours post-operatively ]Changes in the hemostatic profile measured through thrombelastography, thrombin generation test and fibrin structure analysis.
- Change in inflammatory profile [ Time Frame: Baseline and 5.5 hours post-operatively ]Changes in the inflammatory profile are investigated through measures of surface induced activation, inflammation and plasminogen binding.
Information By: Hospital of South West Denmark
Dates:
Date Received: August 28, 2014
Date Started: August 19, 2014
Date Completion:
Last Updated: March 9, 2017
Last Verified: March 2017
