From the Guidelines
For a wound that won't stop bleeding, application of a topical hemostatic agent such as QuikClot or Celox is recommended 1.
Key Considerations
- Alternatively, a dressing impregnated with tranexamic acid (TXA) may be applied directly to the wound 1.
- If available, a tourniquet or hemostatic dressing such as HemCon or XStat may also be used to control bleeding, with the tourniquet applied proximally to the wound for up to 2 hours or until medical attention is received 1.
- Proper application of hemostatic dressings requires training 1.
- The use of topical hemostatic agents should consider several factors, such as the type of bleeding, severity, coagulation status, and each agent’s specific characteristics 1.
- Hemostatic dressings may be of greatest use in severe external bleeding in locations where a tourniquet cannot be applied, or when a tourniquet is not available and standard hemorrhage control is not effective 1.
Types of Hemostatic Agents
- Collagen-based agents
- Gelatine-based agents
- Absorbable cellulose agents
- Oxidised cellulose agents
- Fibrin-based agents
- Synthetic glues or adhesives
- Poly-N-acetyl-glucosamine derived from chitin
- Minerals such as kaolin and zeolite 1
From the FDA Drug Label
These highlights do not include all the information needed to use TRANEXAMIC ACID INJECTION safely and effectively. TRANEXAMIC ACID injection, for intravenous use INDICATIONS AND USAGE Tranexamic acid injection is an antifibrinolytic indicated in patients with hemophilia for short-term use (2 to 8 days) to reduce or prevent hemorrhage and reduce the need for replacement therapy during and following tooth extraction
The FDA drug label does not answer the question.
From the Research
Topical Agents for Bleeding Wounds
- For bleeding wounds that won't achieve hemostasis, topical tranexamic acid (TXA) is a recommended agent 2.
- TXA has been shown to be effective in achieving bleeding cessation in epistaxis, with patients treated with TXA being 3.5 times more likely to achieve bleeding cessation at the first assessment 2.
- Other options for managing bleeding wounds include direct pressure with a nonadherent dressing, dressings impregnated with topical vasoconstrictors or hemostatic dressings or agents, silver nitrate, suture ligation, or electrocautery 3.
- Tissue adhesive glue can also be used to achieve hemostasis in certain types of wounds, such as fingertip dermal avulsion injuries 4.
Considerations for Wound Healing
- Delayed wound healing can be caused by various factors, including metabolic, cardiovascular, infectious, immunological, or drug-related disorders 5.
- Certain drugs, such as cytotoxic antineoplastic and immunosuppressive agents, corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and anticoagulants, can slow wound healing 5.
- Advanced wound dressings, such as silver-oxysalt (AgOx) dressings and oxidized regenerated cellulose/collagen (ORC/C) dressings, can be used to manage delayed wound healing 6.