TXA (topical) in the TJA pt w hx DVT??? si or no

[turnupthevapor]

Our ortho dudes/dudettes wanna use TXA topically in those pt's we normally say NO to.... like those w hx DVT, PE, CVA, etc. Seems like there will clearly be a lower plasma level of the drug and it is effective in the literature in this route to decrease EBL. Question is could it tip the balances in the procoaguable direction ( medicolegal concerns)? looking for a consensus on how to react to this proposal?

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[narcusprince]

Surgeon wants to give txa sprinkles in the field his risk not mine.

 

[Noyac]

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