A Feasibility Trial of Tranexamic Acid for Necrotising Soft-tissue Infections

Necrotising soft tissue infections (NSTIs) — sometimes called 'flesh-eating infections' — are a rare but life-threatening type of deep tissue infection that spreads rapidly and requires urgent surgery to remove affected tissue. This pilot study is testing whether a medication called tranexamic acid (TXA), already commonly used to reduce blood loss in surgery and trauma, might help slow the spread of these devastating infections. TXA is thought to work in NSTI by reducing the breakdown of fibrin — a protein that forms a natural barrier against infection spread. The trial gives intravenous TXA or a placebo twice daily for four days to patients hospitalised with a suspected NSTI. The primary goal is to find out whether a larger definitive trial would be feasible, based on consent rates, treatment completion, and early signs that TXA limits infection spread. This study is open to adults aged 18 and older who have been admitted to hospital with a suspected NSTI and have not yet had their first definitive surgical debridement. People with active blood clots, a personal or family history of spontaneous blood clots, or colour blindness would not be eligible for this trial.