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Three Part Question

In [patients with post-circumcion bleeding] does [topical tranexamic acid] [reduce bleeding]

Clinical Scenario

A 4 year old boy attended the paediatric emergency department following a circumcision for religious reasons earlier that day. He had ongoing bleeding from the surgical site.
Is there any evidence behind the use of topical TXA in the management of these patients.

Search Strategy

Using databases : CINAHL, EMBASE, Medline - last 10 years.
(topical tranexamic acid OR TXA).ti,ab
(post circumcision*
bleed*).ti,ab



1 CINAHL (topical tranexamic acid OR TXA).ti,ab 614
2 CINAHL "TRANEXAMIC ACID"/ 937
3 CINAHL (tranexamic acid).ti,ab 1547
4 CINAHL (1 OR 2 OR 3) 1741
5 CINAHL (post circumcision* bleed*).ti,ab 10
6 CINAHL CIRCUMCISION/ 1847
7 CINAHL (CIRCUMCIS*).ti,ab 1977
8 CINAHL (5 OR 6 OR 7) 2431
9 CINAHL (4 AND 8) 0
10 EMBASE (topical tranexamic acid OR TXA).ti,ab 1942
11 EMBASE "TRANEXAMIC ACID"/ 12744
12 EMBASE (10 OR 11) 13151
13 EMBASE (post circumcision* bleed*).ti,ab 35
14 EMBASE CIRCUMCISION/ 8644
15 EMBASE (CIRCUMCIS*).ti,ab 8083
16 EMBASE (13 OR 14 OR 15) 10281
17 EMBASE (12 AND 16) 52
18 EMBASE 17 [DT 2009-2020] 42
19 Medline (topical tranexamic acid OR TXA).ti,ab 2002
20 Medline "TRANEXAMIC ACID"/ 3331
21 Medline (tranexamic acid).ti,ab 4189
22 Medline (19 OR 20 OR 21) 5717
23 Medline (post circumcision* bleed*).ti,ab 47
24 Medline "CIRCUMCISION, FEMALE"/ 1304
25 Medline "CIRCUMCISION, MALE"/ 5079
26 Medline (CIRCUMCIS*).ti,ab 6369
27 Medline (23 OR 24 OR 25 OR 26) 8388
28 Medline (22 AND 27) 6

Search Outcome

No evidence for the use of topical tranexamic acid in bleeding post circumcision

Comment(s)

There is no conclusive evidence published about the use of topical tranexamic acid in bleeding post circumcision.

Clinical Bottom Line

There is nothing published to date about the use of topical TXA in post circumcision bleeds, therefore it is not possible to conclude whether it is effective.