{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:34:13Z","timestamp":1790656453218,"version":"4.1.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T00:00:00Z","timestamp":1609977600000},"content-version":"vor","delay-in-days":378,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2019,12,26]],"date-time":"2019-12-26T00:00:00Z","timestamp":1577318400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2019,12,26]],"date-time":"2019-12-26T00:00:00Z","timestamp":1577318400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004257","name":"The Liaison Committee between the Central Norway Regional Health Authority","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004257","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009123","name":"the Norwegian University of Science and Technology-NTNU, Trondheim, Norway","doi-asserted-by":"publisher","award":["2016\/29014"],"award-info":[{"award-number":["2016\/29014"]}],"id":[{"id":"10.13039\/100009123","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Liaison Committee between the Central Norway Regional Health Authority"},{"name":"the Norwegian University of Science and Technology-NTNU, Trondheim, Norway","award":["2016\/29014"],"award-info":[{"award-number":["2016\/29014"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,3,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Topical administration of tranexamic acid (TXA) may be an alternative to intravenous administration to reduce bleeding with a lower risk of systemic adverse events. The aim of this study was to investigate whether moistening a surgical wound with TXA before closure, leaving a thin film of drug only, would reduce postoperative bleeding.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a two-centre, stratified, parallel-group, placebo-controlled, double-blind RCT. Patients undergoing mastectomy with or without axillary lymph node clearance were randomized 1 : 1 to moistening of wound surface before closure with either 25 mg\/ml TXA or 0\u00b79 per cent sodium chloride (placebo). The primary endpoint was postoperative bleeding as measured by drain production in the first 24 h. Secondary endpoints were early haematoma, total drain production, postoperative complications and late aspirations of seroma within 3 months.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Between 1 January 2016 and 31 August 2018, 208 patients were randomized. Two patients were converted to a different surgical procedure at surgery, and four did not receive the intervention owing to technical error. Thus, 202 patients were included in the study (101 in the TXA and 101 in the placebo group). TXA reduced mean drain production at 24 h (110 versus 144 ml; mean difference 34 (95 per cent c.i. 8 to 60)\u00a0ml, P\u00a0=\u00a00\u00b7011). One patient in the TXA group had early haematoma compared with seven in the placebo group (odds ratio (OR) 0\u00b713 (95 per cent c.i. 0\u00b702 to 1\u00b707); P\u00a0=\u00a00\u00b7057). There was no significant difference in postoperative complications between TXA and placebo (13 versus 10; OR 1\u00b711 (0\u00b745 to 2\u00b773), P\u00a0=\u00a00\u00b7824) or need for late seroma aspirations (79 versus 67 per cent; OR 1\u00b783 (0\u00b791 to 3\u00b768), P\u00a0=\u00a00\u00b7089).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Moistening the wound with TXA 25 mg\/ml before closure reduces postoperative bleeding within the first 24 h in patients undergoing mastectomy. Registration number: NCT02627560 (https:\/\/clinicaltrials.gov).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs5.50248","type":"journal-article","created":{"date-parts":[[2019,12,26]],"date-time":"2019-12-26T08:19:34Z","timestamp":1577348374000},"page":"216-224","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":60,"title":["Topical moistening of mastectomy wounds with diluted tranexamic acid to reduce bleeding: randomized clinical trial"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6247-5608","authenticated-orcid":false,"given":"K","family":"Ausen","sequence":"first","affiliation":[{"name":"Section for Plastic and Reconstructive Surgery, Clinic of Surgery, St Olav's University Hospital , Trondheim, Norway"},{"name":"Department of Circulation and Medical Imaging, Norwegian University of Science and Technology , Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A I","family":"Hagen","sequence":"additional","affiliation":[{"name":"Section for Breast and Endocrine Surgery, Clinic of Surgery, St Olav's University Hospital , Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H S","family":"\u00d8stbyhaug","sequence":"additional","affiliation":[{"name":"Section for Breast and Endocrine Surgery, Clinic of Surgery, St Olav's University Hospital , Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Olafsson","sequence":"additional","affiliation":[{"name":"Section for Breast and Endocrine Surgery, Department of Surgery, \u00c5lesund Hospital, M\u00f8re and Romsdal Hospital Trust , \u00c5lesund, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B J","family":"Kvalsund","sequence":"additional","affiliation":[{"name":"Section for Breast and Endocrine Surgery, Department of Surgery, 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