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Three-part question
In patients with postcircumcision bleeding, does topical tranexamic acid (TXA) 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
CINAHL (topical tranexamic acid OR TXA).ti,ab 614
CINAHL "TRANEXAMIC ACID"/ 937
CINAHL (tranexamic acid).ti,ab 1547
CINAHL (1 OR 2 OR 3) 1741
CINAHL (post circumcision* bleed*).ti,ab 10
CINAHL CIRCUMCISION/ 1847
CINAHL (CIRCUMCIS*).ti,ab 1977
CINAHL (5 OR 6 OR 7) 2431
CINAHL (4 AND 8) 0
EMBASE (topical tranexamic acid OR TXA).ti,ab 1942
EMBASE "TRANEXAMIC ACID"/ 12744
EMBASE (10 OR 11) 13151
EMBASE (post circumcision* bleed*).ti,ab 35
EMBASE CIRCUMCISION/ 8644
EMBASE (CIRCUMCIS*).ti,ab 8083
EMBASE (13 OR 14 OR 15) 10281
EMBASE (12 AND 16) 52
EMBASE 17 [DT 2009-2020] 42
Medline (topical tranexamic acid OR TXA).ti,ab 2002
Medline “TRANEXAMIC ACID”/ 3331
Medline (tranexamic acid).ti,ab 4189
Medline (19 OR 20 OR 21) 5717
Medline (post circumcision* bleed*).ti,ab 47
Medline “CIRCUMCISION, FEMALE”/ 1304
Medline “CIRCUMCISION, MALE”/ 5079
Medline (CIRCUMCIS*).ti,ab 6369
Medline (23 OR 24 OR 25 OR 26) 8388
Medline (22 AND 27) 6
Search outcome
No evidence for the use of topical TXA in postcircumcision bleeding.
Comment
There is no conclusive evidence published about the use of topical TXA in postcircumcision bleeding.
Clinical bottom line
There is nothing published to date about the use of topical TXA in postcircumcision bleeds; therefore, it is not possible to conclude whether it is effective.