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. 2025 May 6;30(1):366.
doi: 10.1186/s40001-025-02634-z.

Topical tranexamic acid prevents scar tissue formation following craniectomy in a rat model

Ömer Şahin  1 , Tuncer Taşcıoğlu  2 , Ayşegül Fırat  3 , Hüseyin Selçuk Sürücü  4 , Muzaffer Çaydere  5
Affiliations

Topical tranexamic acid prevents scar tissue formation following craniectomy in a rat model

Ömer Şahin et al. Eur J Med Res. .

Abstract

Background: We carried out a study to assess the efficacy of tranexamic acid in preventing scar tissue in the craniectomy area in rats.

Method: Our study consisted of control and tranexamic acid groups with 10 subjects each. All subjects underwent bilateral frontoparietal craniectomy. After craniectomy, cotton pads were applied to the surgical sites. In the controls, the pads were soaked with saline and in the tranexamic acid group the pads were soaked with 30 mg/kg tranexamic acid. Rats were decapitated 30 days after surgery. The degree of scar formation was evaluated pathologically and by electron microscopy. In pathologic evaluation, dura mater thickness, scar tissue density, and arachnoid involvement were evaluated.

Results: The outcomes demonstrated that no adhesions were present in the rats of the Tranexamic acid group, whereas the control group exhibited severe scar tissue [eight of ten rats (80%)] with adhesions. Additionally, comparison between the two groups showed that the dura mater thickness of tranexamic acid animals was thinner than that of the control group animals. Similarly, the intensity of scar tissue density and the intensity of arachnoid involvement were much better than the control group.

Conclusions: Scar tissue formation following craniectomies represents a significant adverse outcome that may lead to various complications. Intraoperative topical application of tranexamic acid has demonstrated potential efficacy in preventing scar formation in the craniectomy region in rat models.

Keywords: Craniectomy; Epidural fibrosis; Rat; Tranexamic acid.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was conducted with the approval of Ankara Training and Research Hospital Animal Experiments and Local Ethics Committee decision with permission number 775. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Control group pathological evaluation shows Grade 3 fibrosis. C cranium, F fibrosis, Asterix dura mater. Masson trichrome
Fig. 2
Fig. 2
Tranexamic acid group pathological evaluation shows Grade 1 fibrosis. There wasn’t any direct contact among the underlying dura mater with the fibrotic tissue. C cranium, F fibrosis, B brain, White arrow dura mater. Masson trichrome
Fig. 3
Fig. 3
Control group electron microscopy demonstrates. A Dural section with active fibroblast (F) with well-developed rough endoplasmic reticulum (RER) and collagen fibers (C). B Active fibroblast (F) with well oriented collagen bundles (C) are observed. In the opposite corner of the picture blood elements are seen (B). C Thick bundles of collagen bundles (C) overlaying active fibroblast (F) are observed. Some erythrocytes (R) are seen in the dural space
Fig. 4
Fig. 4
Tranexamic acid group electron microscopy demonstrates: A Collagen fibers (C) in various directions and a fibrocyte (F) are observed. B Collagen fibers (C) extending in various directions and a less active fibroblast (F) is observed. C Collagen fibers (C) extending in various directions and a less active fibroblast (F) is observed
See this image and copyright information in PMC

References

    1. Abitbol JJ, Lincoln TL, Lind BI, Amiel D, Akeson WH, Garfin SR. Preventing postlaminectomy adhesion A new experimental model. Spine. 1994;19(16):1809–14. 10.1097/00007632-199408150-00004. - PubMed
    1. Bora H, Aykol SV, Akyürek N, Akmansu M, Ataoglu O. Inhibition of epidural scar tissue formation after spinal surgery: external irradiation vs. spinal membrane application. Int J Radiat Oncol Biol Phys. 2001;51(2):507–13. 10.1016/s0360-3016(01)01647-9. - PubMed
    1. Cemil B, Tun K, Kaptanoglu E, Cevirgen B, Gurcay AG, Kaymaz F, Tekdemir I. The effect of mitomycin C as fibrosis preventive agent during craniectomies. Br J Neurosurg. 2009;23(3):304–8. 10.1080/02688690802603913. - PubMed
    1. Cho YJ, Kang SH. Review of cranioplasty after decompressive craniectomy. Korean J Neurotrauma. 2017;13(1):9–14. 10.13004/kjnt.2017.13.1.9. - PMC - PubMed
    1. Circi E, Atici Y, Baris A, Senel A, Leblebici C, Tekin SB, Ozturkmen Y. Is tranexamic acid an effective prevention in the formation of epidural fibrosis? Histological evaluation in the rats. J Korean Neurosurg Soc. 2023;66(5):503–10. 10.3340/jkns.2022.0249. - PMC - PubMed

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