Safety and clinical outcomes associated with the routine use of tranexamic acid (TXA) in abdominal-based free flap autologous breast reconstruction — a case control study

Moursi, Amr Adel Moustafa; Ibrahim, Mina; Awad, Guirgis Arsanios

doi:10.1007/s00238-022-02027-z

Cited by 2 publications

(2 citation statements)

References 44 publications

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“…17 Strategies to reduce blood loss, such as the use of tranexamic acid perioperatively, have also been associated with decreased rates of transfusion, and these should be further explored in trauma patients requiring LE reconstruction. 18,19…”

Section: Discussionmentioning

confidence: 99%

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The Hidden Risks of Perioperative Transfusions in Traumatic Lower Extremity Free Flap Reconstruction

Swiekatowski,

Manisundaram,

Woods

et al. 2024

J Reconstr Microsurg

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Background Blood transfusions have been associated with surgical complications; however, these studies are not specific to lower extremity (LE) reconstruction. We evaluated the effect of perioperative packed red blood cell (PRBC) transfusions on LE free flap outcomes in trauma patients. Methods Patients undergoing LE free flap reconstruction following acute injuries from 2016 to 2021 were retrospectively analyzed. The perioperative period for transfusions was defined as ± 3 days from the procedure. Parameters included demographics, perioperative characteristics, and outcomes. Major complications were complications requiring reoperation. Univariate and multivariate analyses were performed to identify associations. Results Of the 205 patients, 48% received PRBCs perioperatively. There was a trend toward higher major complications rate in the transfusion group (19 vs. 10%, p = 0.09). Wound size, injury severity score (ISS), and intraoperative estimated blood loss were greater in the transfusion group (p < 0.01). Preoperative hemoglobin/hematocrit were lower in the transfusion group (p < 0.001). Units of PRBCs transfused were independently associated with major complications on multivariate analysis (odds ratio [OR] = 1.34, confidence interval [CI]: 1.06–1.70, p = 0.015) and length of hospital stay (LOS; OR = 1.05, CI: 1.02–1.08, p = 0.002). Infection, wound size, ISS, and preoperative hemoglobin/hematocrit were independently associated with increased LOS (p < 0.05) but not with major complications. Conclusion The number of units of PRBCs given perioperatively was the only variable independently associated with major complications on multivariate analysis and was one of many variables associated with increased LOS. These findings suggest the usage of restrictive transfusion protocols in trauma patients requiring LE reconstruction.

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Section: Discussionmentioning

confidence: 99%

“…Manuscript and these should be further explored in trauma patients requiring lower extremity reconstruction. 18,19…”

Section: Accepted Manuscriptmentioning

confidence: 99%

The Hidden Risks of Perioperative Transfusions in Traumatic Lower Extremity Free Flap Reconstruction

Swiekatowski,

Manisundaram,

Woods

et al. 2024

J Reconstr Microsurg

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Meta analysis of 2059 patients assessing early discharge after DIEP flap breast reconstruction: Comprehensive outcomes before post-operative day 5

Jagasia,

Torres-Guzman,

Dash

et al. 2024

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Safety and clinical outcomes associated with the routine use of tranexamic acid (TXA) in abdominal-based free flap autologous breast reconstruction — a case control study

Cited by 2 publications

References 44 publications

The Hidden Risks of Perioperative Transfusions in Traumatic Lower Extremity Free Flap Reconstruction

The Hidden Risks of Perioperative Transfusions in Traumatic Lower Extremity Free Flap Reconstruction

Meta analysis of 2059 patients assessing early discharge after DIEP flap breast reconstruction: Comprehensive outcomes before post-operative day 5

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