Breast Cancer Clinical Trial
Official title:
Tranexamic Acid Usage in Bilateral Mastectomy to Reduce Post-surgical Drainage
Tranexamic acid (TxA) is a drug that was approved by the FDA in 1986. It is an antifibrinolytic drug - this means that it is used to promote blood clotting by preventing the breakdown of blood clots that the participant's body naturally forms. TxA is very commonly used to control bleeding in a variety of surgeries, such as orthopedic and gynecologic procedures, and is available in both the injectable (delivering the drug through the veins) and oral forms. However, its use is still not commonplace in the setting of elective breast surgery, because it hasn't been extensively studied in this field. Because it is not currently FDA-approved for use in elective breast surgery, this would make the drug "investigational" for this study. Because of its current use in other fields, TxA seems to have a great deal of potential in reducing the amount of post-operative time that breast drains need to be kept in place, the frequency of adverse events during wound healing such as bleeding and fluid accumulation, and overall fluid drainage amount. This would serve to improve the overall process of post-operative healing following a mastectomy procedure. Currently, the use of TxA is approved through the injectable route at Northwestern, but it is not approved for administration by the topical route. Previous studies have shown that TxA given through the topical route of administration in breast reduction surgery reduced post-surgical drainage and fluid accumulation. In this study, the use of 3% (3 grams of TxA in 100 ml of saline) TxA through the topical route by applying it to the breast wound of one breast as a direct fluid irrigation will be investigated. This will be done as a fluid wash, where the TxA will be in a syringe, and just before wound closure the TxA will be sprayed onto the wound site. The other breast will undergo the same procedure, but will receive normal saline solution instead of TxA. The procedure of interest here is a prophylactic bilateral mastectomy, which is a mastectomy that is performed to prevent the occurrence of breast cancer. The purpose of this study is to test whether applying TxA topically during wound closure in mastectomy procedures will affect the quantity of fluid accumulation and bleeding, and the amount of time that post-operative drains need to be kept in place.
Status | Recruiting |
Enrollment | 30 |
Est. completion date | December 2024 |
Est. primary completion date | December 2024 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | Female |
Age group | 18 Years to 80 Years |
Eligibility | Inclusion Criteria: - Female aged 18 years or older - Scheduled or plans to schedule a bilateral mastectomy - Able to understand informed consent and sign it voluntarily Exclusion Criteria: - Male without breasts - Females who have previously undergone either unilateral or bilateral mastectomy as they do not have breasts on which the drug could be tested - Patients with a hypersensitive or allergic reaction to TxA - Patients with an active clotting disorder - Patients with a subarachnoid hemorrhage within the past 3 months of screening - Patients on chronic, extracorporeal renal replacement therapy |
Country | Name | City | State |
---|---|---|---|
United States | AMITA Health Saint Joseph Chicago | Chicago | Illinois |
United States | Northwestern Memorial Hospital | Chicago | Illinois |
Lead Sponsor | Collaborator |
---|---|
Northwestern University | Northwestern Memorial Hospital, Saint Joseph Hospital, Chicago, Illinois |
United States,
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* Note: There are 19 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Drain output | The primary clinical endpoints in this study are the post-surgical drainage volume and drainage system indwelling time. Each drainage system will be removed post-operatively when the drainage amount is equal to or less than 30cc's for two consecutive 24-hour periods. Additionally, observations will be made regarding the post-surgical fluid accumulation, such as hematoma and seroma formation, and characterization of the fluid (bloody, purulent, serosanguinous, etc.) | Approximately 1 month post-operatively | |
Secondary | Safety evaluation | The primary safety endpoint will be the development of previously noted side effects in studies of TxA usage - primarily headache, diarrhea and nausea predominantly associated with oral administration of TxA - as self-reported by the participants of those studies. Incidence of all side effects will be monitored. | Approximately 1 month post-operatively |
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