Efficacy of Topical Tranexamic Acid (Cyclokapron) in “Wet” Field Infiltration with Dilute Local Anaesthetic Solutions in Plastic Surgery

Fayman, Moshe S.; Beeton, A.; Potgieter, Estelle; Ndou, Robert; Mazengenya, Pedzisai

doi:10.1007/s00266-020-02001-9

Cited by 17 publications

(24 citation statements)

References 32 publications

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“…Only 2 studies regarding TXA use in liposuction are available up till now. First is the study by Cansancao et al, where the IV route was chosen to estimate its effect on blood loss in 20 liposuction patients [ 2 ], while the other one by Fayman et al used local TXA infiltration to study its effect on bruising tendency in one flank compared to the other that was used as control in 33 patients [ 15 ], compared to 90 patients in this study. While the previously mentioned studies compared control group to either IV or local TXA administration, comparing IV as well as local infiltration to a control group has never been done before in previous plastic surgery studies, making this the first study, to our knowledge, to discuss this matter.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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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.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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“…The results were statistically significant (p = 0.015 and p = 0.0001, respectively) with a decrease in bruising on the treatment side compared to the control side on day 1 and day 7, respectively. [3] In Cansancao et al, the use of TXA in the tumescent infiltration for liposuction allowed for 114% more aspiration of fat in the TXA group [53].…”

Section: Aesthetic Surgery/breast Surgerymentioning

confidence: 99%

“…Anti-fibrinolytic agents have been used in recent years to avoid such complications and to prevent predisposing the patients to higher rates of infection, compromised cosmetic outcomes, further surgical intervention, or the need for blood transfusions. [2] The use of tranexamic acid (TXA) in plastic surgery has been frequently described for the use in cranio-and maxillo-facial surgery [3]. Over the years, TXA has become an invaluable agent in the fields of orthopedic and cardiac surgery as a means to minimize blood loss [3].…”

Section: Introductionmentioning

confidence: 99%

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Tranexamic acid in plastic surgery: routes of administration and dosage considerations

et al. 2021

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Background Excessive blood loss, during or after surgery, remains a major surgical concern despite the continuous improvement of surgical standards. Tranexamic acid (TXA), an anti-fibrinolytic, is a potential agent that has been used in a variety of methods to mitigate blood loss. In addition, TXA shows additional anti-inflammatory effects which may be of particular interest. The objective of this study is to review clinical studies involving the use of TXA in plastic surgery related procedures. Methods We carried out a literature search of Google Scholar, PubMed, Ovid Medline, and Cochrane databases since their inception for relevant clinical studies on TXA use (dosages/routes of administration) in plastic surgery-related procedures. Results Forty-five articles were included in this review. These included studies assessing the use of TXA in craniofacial surgery (15 studies), aesthetic and breast-related surgeries (23 studies), burn care (4 studies), and microsurgery (3 studies). For each subset, study design, study sample size, surgical procedure performed, TXA route of administration, dosage, study outcomes, and adverse events were summarized and reported in a separate section. Conclusions TXA is widely studied in the field of craniofacial surgery, specifically craniosynostosis surgery. Intravenous administration of TXA is the most commonly studied route of administration. Topical formulations seem to be on the rise and the added local anti-inflammatory effects and safety profile of topical use add significant appeal. Moreover, evidence on appropriate dosage protocols is scarce. The variable approach in dosing warrants further trials to assess the clinical implications, as well as potential benefit in using TXA more efficiently in the field of plastic surgery, as a whole. Level of evidence: Not ratable

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“…In our practice and in the literature, we have found 1000 mg IV to be a safe and convenient dosage. It would also be of benefit to objectively measure dermal bleeding by weighing blood loss, as Dr. Couto suggests, and to quantify bruising through a surface area measurement, as shown by Fayman et al 5 …”

mentioning

confidence: 99%

Considerations for Differentiating the Effects of Intravenous and Topical Tranexamic Acid in Liposuction in Future Research Protocols

Stoehr

Fine

2021

Aesthetic Surgery Journal Open Forum

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Efficacy of Topical Tranexamic Acid (Cyclokapron) in “Wet” Field Infiltration with Dilute Local Anaesthetic Solutions in Plastic Surgery

Cited by 17 publications

References 32 publications

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

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

Tranexamic acid in plastic surgery: routes of administration and dosage considerations

Considerations for Differentiating the Effects of Intravenous and Topical Tranexamic Acid in Liposuction in Future Research Protocols

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