Best Evidence Topic reports

Emerg Med J: first published as 10.1136/emermed-2021-211306.3 on 19 March 2021. Downloaded from http://emj.bmj.com/ on August 22, 2022 at Universidad de Chile 2224 Medicina
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BET 2: Topical tranexamic acid in

postcircumcision bleeding
Authors: Alannah Madden, Peter Hulme
Affiliation: Manchester Royal Infirmary, Manchester,
Manchester, UK

322    Emerg Med J April 2021 Vol 38 No 4


Three-part question
In patients with postcircumcision bleeding,
does topical tranexamic acid (TXA) reduce
bleeding?
Clinical scenario
A 4-­ year-­
old boy attended the paedi-
atric 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 T​ XA).​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
Emerg Med J April 2021 Vol 38 No 4
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
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.
Best Evidence Topic reports
Emerg Med J: first published as 10.1136/emermed-2021-211306.3 on 19 March 2021. Downloaded from http://emj.bmj.com/ on August 22, 2022 at Universidad de Chile 2224 Medicina
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 TXA in
postcircumcision bleeding.
Comment
There is no conclusive evidence published
about the use of topical TXA in postcir-
cumcision bleeding.
Funding  The authors have not declared a specific
grant for this research from any funding agency in the
public, commercial or not-­for-­profit sectors.
Competing interests  None declared.
Patient consent for publication  Not required.
Provenance and peer review  Not commissioned;
Norte. Protected by copyright.
internally peer reviewed.
© Author(s) (or their employer(s)) 2021. No commercial
re-­use. See rights and permissions. Published by BMJ.
Emerg Med J 2021;38:322–323.
doi:10.1136/emermed-2021-211306.3
323