The effect of tranexamic acid on blood loss in liposuction: a randomized controlled study

Abstract

Background Liposuction is one of the most common procedures in the practice of plastic surgery. Since it evolved, continuous modifications have been to decrease blood loss so that patients are hemodynamically stable intra- and postoperatively. Tranexamic acid (TXA) has long been used for its antifibrinolytic properties that were beneficial in reducing blood loss, rate of transfusion, and hemoglobin drop in major trauma and surgeries. Its use in plastic surgery, however, is still limited. In this study, we aim to illustrate the effect of intravenous (IV) and local infiltration of TXA on blood loss in liposuction surgery. Methods Between April 2019 and April 2021, 90 patients who requested liposuction for various body parts were randomly allocated into 3 equal groups: control group, IV TXA, and local infiltration of TXA. A sample was taken from infranatant and sent for hematocrit calculation. Volume of blood in lipoaspirate was then calculated. Patients were assessed for blood loss and postoperative bruising. Results Volume of blood loss in lipoaspirate was considerably lower in the TXA groups, with 60% decrease in blood loss for the local TXA group in comparison with the control group. TXA has also been shown to markedly decrease bruising tendency in postoperative liposuction patients. Conclusions TXA can be used to decrease blood loss in large-volume liposuction, modify the need for blood transfusion intra- and postoperative, and improve the results of liposuction procedure without the need for multiple sessions. Level of evidence: Level II, Risk/Prognostic Study.

Effectiveness of Tranexamic Acid in the Postoperative Period in Body Contour Surgery: Randomized Clinical Trial

“…El Minawi et al also found significantly less bleeding and a lower incidence and severity of ecchymosis in patients who were administered TXA by subcutaneous infiltration for tumescence or IV half an hour before starting surgery compared with a control group. 19 In this study, bleeding was less with subcutaneous administration than with IV administration. Hoyos et al found, in a multicenter, randomized, double-blind study, greater effectiveness when using IV TXA half an hour before the start of liposuction, than when using it in the tumescent subcutaneous infiltration than in the placebo group.…”

“…5 Although TXA is a product widely used in various areas of medicine and surgery, [6][7][8][9][10][11][12] only recently has it been used in different surgical procedures in the field of plastic surgery, [13][14][15][16] including body contouring surgery. [17][18][19][20] The usefulness of TXA has already been determined during liposuction, in different forms and processes with very good results. [17][18][19][20] However, there is no comparative study that evaluates the effect and possible benefits of continuing its administration for 48 hours after surgery.…”

“…[17][18][19][20] The usefulness of TXA has already been determined during liposuction, in different forms and processes with very good results. [17][18][19][20] However, there is no comparative study that evaluates the effect and possible benefits of continuing its administration for 48 hours after surgery. That is why we developed a comparative protocol using it in the transoperative period and continuing its use during the immediate postsurgical period to find out the benefits provided by this scheme and to evaluate possible complications, with the aim of reducing bleeding and the amount of blood transfusions.…”

Treatment with selective transcatheter arterial embolization of a ruptured profunda artery perforator after internal thigh liposuction: a case report

“…Despite the use of blunt cannulas, liposuction generates trauma of the subcutaneous vessels and inevitably leads to mild to moderate bleeding in the fat layers. Epinephrin of the tumescent infiltration reduces bleeding, and tranexamic acid can also be used to reduce blood loss, especially in high-volume liposuctions [ 15 , 16 ]. As described here, massive hemorrhage with active bleeding after liposuction is an infrequent complication with potentially life-threatening consequences if not appropriately addressed [ 9 , 17 ].…”

Rolle der Tranexamsäure in der Plastischen Chirurgie: eine systematische Überprüfung

“…Es konnte eine signifikante Reduktion des Blutverlustes im Lipoaspirat durch die subkutane Gabe von Tranexamsäure im Vergleich zur Kontrollgruppe festgestellt werden. Des Weiteren konnte festgestellt werden, dass die Ausbildung von Hauthämatomen sowohl durch die subkutane als auch intravenöse Applikation von Tranexamsäure deutlich reduziert werden konnte 27 .…”