Abstract
BACKGROUND
Brimonidine topical gel may be useful in cutaneous surgical procedures because of its vasoconstricting properties.
OBJECTIVE
Assess the hemostatic effect of topically applied brimonidine in patients being treated with anticoagulants and undergoing Mohs micrographic surgery (MMS).
METHODS
Subjects undergoing MMS were randomly assigned to the control (n = 10) or study arm (n = 14). Controls received standard-of-care MMS, whereas the study arm received the same and preoperative application of brimonidine. Evaluations included rate of blood flow, percentage of wound bed surface area needing electrocautery, and changes in skin colorimeter readings.
RESULTS
The treatment arm had 68% less blood loss over 30 seconds versus the control arm (P < .05). No patient in the brimonidine arm had more than 50% of the wound bed cauterized versus 80% in the controls. Erythema in the treatment arm was decreased by 3.89 times (P < .01) versus in the control arm.
LIMITATIONS
Limitations were small sample size; sites limited to the face; the fact that measurement of bleeding did not account for anesthetic mixed with blood; visual estimation of percentage of wound surface area requiring cauterization; and no measurement of volume of anesthesia, wound depth, or postoperative complications.
CONCLUSION
Preoperative application of brimonidine 0.33% gel may help decrease blood loss and the need for electrocautery during MMS for patients taking anticoagulants.
TY - JOUR
T1 - Randomized controlled pilot study of the preoperative use of brimonidine 0.33% topical gel for hemostasis in Mohs micrographic surgery.
AU - Chen,Edward,
AU - Patel,Raj Ajay,
AU - Kwak,Young Jin,
AU - Huang,Conway C,
Y1 - 2017/10/12/
PY - 2016/09/02/received
PY - 2017/08/06/revised
PY - 2017/08/09/accepted
PY - 2017/10/17/pubmed
PY - 2017/12/12/medline
PY - 2017/10/17/entrez
KW - Mohs micrographic surgery
KW - anticoagulants
KW - brimonidine
KW - electrocautery
KW - hemostasis
KW - nonmelanoma skin cancer
SP - 1114
EP - 1118
JF - Journal of the American Academy of Dermatology
JO - J Am Acad Dermatol
VL - 77
IS - 6
N2 - BACKGROUND: Brimonidine topical gel may be useful in cutaneous surgical procedures because of its vasoconstricting properties. OBJECTIVE: Assess the hemostatic effect of topically applied brimonidine in patients being treated with anticoagulants and undergoing Mohs micrographic surgery (MMS). METHODS: Subjects undergoing MMS were randomly assigned to the control (n = 10) or study arm (n = 14). Controls received standard-of-care MMS, whereas the study arm received the same and preoperative application of brimonidine. Evaluations included rate of blood flow, percentage of wound bed surface area needing electrocautery, and changes in skin colorimeter readings. RESULTS: The treatment arm had 68% less blood loss over 30 seconds versus the control arm (P < .05). No patient in the brimonidine arm had more than 50% of the wound bed cauterized versus 80% in the controls. Erythema in the treatment arm was decreased by 3.89 times (P < .01) versus in the control arm. LIMITATIONS: Limitations were small sample size; sites limited to the face; the fact that measurement of bleeding did not account for anesthetic mixed with blood; visual estimation of percentage of wound surface area requiring cauterization; and no measurement of volume of anesthesia, wound depth, or postoperative complications. CONCLUSION: Preoperative application of brimonidine 0.33% gel may help decrease blood loss and the need for electrocautery during MMS for patients taking anticoagulants.
SN - 1097-6787
UR - https://www.unboundmedicine.com/medline/citation/29031658/Randomized_controlled_pilot_study_of_the_preoperative_use_of_brimonidine_0_33_topical_gel_for_hemostasis_in_Mohs_micrographic_surgery_
DB - PRIME
DP - Unbound Medicine
ER -
