Baghaie, H.Shukla, K.Stone, J.Breik, O.Munn, Z.2024-06-242024-06-242023JBI evidence synthesis, 2023; 21(2):430-4402689-83812689-8381https://hdl.handle.net/2440/141425OBJECTIVE: The objective of the review is to evaluate the effectiveness of perioperative prophylactic tranexamic acid for reducing blood loss in orthognathic surgery in healthy patients. INTRODUCTION: Orthognathic surgery can cause significant hemorrhage, which requires postoperative blood transfusions. The most widely studied pharmaceutical adjunct for reducing blood loss is tranexamic acid, a synthetic amino acid that reversibly inhibits plasminogen activation. It is widely used and validated in other surgical procedures to limit blood loss; however, it is not a gold standard in orthognathic surgery. INCLUSION CRITERIA: We will include clinical trials comparing tranexamic acid to appropriate controls. The primary outcomes are intraoperative blood loss, change in hematocrit/hemoglobin level, and need for blood transfusion. Secondary outcomes include operating time, length of hospital stay, and adverse reactions. Studies of patients with preexisting coagulopathies and those undergoing only minor orthognathic surgery (eg. genioplasty) will be excluded. METHODS: We will search three electronic databases (PubMed, Embase, and Cochrane Library) from database inception. Titles, abstracts, and full-text papers will be assessed against the inclusion criteria by two independent reviewers. Risk of bias will be assessed using the Cochrane Risk of Bias 2.0 tool. Data will be extracted by two independent reviewers. Meta-analysis will be conducted for all outcomes where appropriate, with weighted mean differences used for intraoperative blood loss, changes in hematocrit/hemoglobin levels, operation time, and length of stay; and risk ratio for transfusion rates and adverse outcomes. Certainty of the evidence will be presented using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.en© 2022 JBIantifibrinolytic; blood loss; hemostatic; maxillofacial; osteotomyHumansBlood Loss, SurgicalTranexamic AcidHemoglobinsAntifibrinolytic AgentsReview Literature as TopicMeta-Analysis as TopicOrthognathic SurgerySystematic Reviews as TopicJournal article10.11124/JBIES-22-001262024-06-20622143Stone, J. [0000-0002-3787-6175] [0000-0002-7848-1401]Munn, Z. [0000-0002-7091-5842]