Local delivery of tranexamic acid for hemorrhage control in trauma: a narrative review

TXA demonstrates effectiveness in hemorrhage control through local delivery, either integrated with hemostatic materials or administered via IM and IO routes as practical alternatives to IV infusion in emergency settings. Future research should prioritize formulation optimization, integration of smart features for controlled release, and clinical validation to enable widespread adoption in prehospital and battlefield environments. While topical TXA has shown safety and efficacy in surgical contexts, additional clinical trials are required to confirm its role in traumatic hemorrhage and establish standardized protocols. These innovations offer practical and physiological advantages for managing bleeding, particularly in resource-limited and battlefield environments. Further research is needed to validate safety, scalability, and clinical efficacy across diverse trauma scenarios.