Influence of Tranexamic Acid in Body Contouring Surgery: Significant Changes on Complication Rates after Abdominoplasty

The current state of tranexamic acid in mastectomy and breast reconstruction: A systematic review and meta-analysis

BACKGROUND

The use of tranexamic acid (TXA) in breast surgery has been increasing; however, there have been no recent studies synthesizing the most current data. The purpose of this study was to perform a comprehensive targeted analysis on the impact of TXA in mastectomy with and without breast reconstruction.

METHODS

A systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analysis guidelines. Five databases were queried to identify studies using TXA in breast surgery. Dual-screening was employed to identify studies on mastectomy with and without breast reconstruction for full-text evaluation. Outcomes assessed included postoperative hematoma, seroma, surgical site infection (SSI), drain output, and drain duration. Data were pooled, and meta-analysis was performed. Odds ratios (OR) and mean differences (MD) were reported via the Mantel-Haenszel and Inverse-Variance methods, respectively.

RESULTS

Thirteen studies totaling 2115 patients were included, with 44% of the patients (n=926) receiving TXA. Overall, 83% of the patients (n=772) received TXA intraoperatively and 82% of (n=632) received intravenous administration. Postoperative hematoma occurred in 2.4% of the patients (n=18) in the TXA group compared to 5.5% of the patients (n=53) in the control group, representing 60% decreased odds (OR 0.40; 95% CI [0.23-0.70], P = 0.001) of hematoma formation. TXA administration significantly reduced drain duration and 24-hour drain output by 1.2 days and 41.8 mL, respectively (MD: -1.2; P = 0.03; MD: -41.8; P = 0.002). TXA administration did not significantly impact the rates of seroma formation or SSI.

CONCLUSION

TXA administration was found to significantly reduce postoperative hematoma formation, drain duration, and 24-hour drain output, without impacting seroma or SSI rates.

The Use of Tranexamic Acid in Breast Reduction and Abdominoplasty: A Review of a Multicenter Federated Electronic Health Record Database

Background

Tranexamic acid (TXA), a fibrinolysis inhibitor, is widely used in various surgical fields to minimize blood loss. However, its efficacy and safety in plastic surgery, especially in reduction mammaplasty and abdominoplasty, remain underexplored. This study investigates the utility of intravenous (IV) TXA in these procedures, focusing on reducing postoperative complications and evaluating its safety in the context of venous thromboembolism (VTE).

Objectives

To evaluate the efficacy and safety of TXA in reduction mammaplasty and abdominoplasty.

Methods

Using data from the TriNetX LLC (Cambridge, MA) National Health Research Network database, this retrospective study compared adult patients undergoing reduction mammaplasty or abdominoplasty who received intraoperative IV TXA against those who did not. Primary outcomes included postoperative seroma and hematoma incidences, whereas secondary outcomes assessed the necessity for procedural drainage and the occurrence of VTE within 1-year postsurgery.

Results

No significant differences in the rates or risks of hematoma, seroma, or the need for procedural drainage between patients administered IV TXA and those who were not, for both reduction mammaplasty and abdominoplasty. Additionally, IV TXA did not increase the risk of VTE in either patient group.

Conclusions

IV TXA application in reduction mammaplasty and abdominoplasty does not provide added benefits in reducing postoperative complications such as seroma, hematoma, or the necessity for procedural drainage. Furthermore, it does not alter the risk of thromboembolic events. These findings highlight the need for further research, particularly through randomized control trials, to understand TXA's efficacy in plastic surgery.

Level of Evidence 3 Therapeutic