Late postoperative massive bleeding in septorhinoplasty: A prospective study

Ors, Safvet; Ozkose, Mehmet

doi:10.1177/229255031602400209

Cited by 9 publications

(9 citation statements)

References 16 publications

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“…21 However, owing to its rebounding activity and systemic cardiovascular side effects such as tachycardia, it can be used sparingly. 22 In our research, hemodynamic changes such as heart rate and systolic blood pressure were not observed following surgery. Also, in the current study, no side effects were observed due to increasing the dose of epinephrine, and also considering the cheapness and availability of this drug in terms of cost-effectiveness, it seems reasonable to use a higher dose of this drug depending on the surgeon.…”

Section: Discussionmentioning

confidence: 48%

Comparative evaluation about the efficacy of the use of variable concentrations of Epinephrine in Tumescent solution for control of bleeding in patients with abdominal liposuction

Farhadi

Khorshidifar

Ghalambor

et al. 2020

J. Contemp. Med. Sci.

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Introduction: The use of epinephrine for controlling the blood loss has gained out in many dermatological surgeries; however, its use in liposuction has not been studied. In this regard, we aimed to figure out the effectiveness of using epinephrine in tumescent solution during liposuctions surgery. Material and Methods: In this study we present a prospective, double-blind, nonrandomized study evaluating the effects of adding epinephrine to tumescent solution intra-operative in patients undergoing liposuction. Thirty-six patients including 6 males and 29 females undergoing liposuction were divided into two groups. In case group we use 1-1.4 mg/L epinephrine (based on the location of surgery) in tumescent solution; and control group did not receive epinephrine. Lab data such as hemoglobin and hematocrit as well as clinical data including blood pressure and heart rate were recorded before, after 1h and 6h of liposuction. Results: In this study, we observed that both case and control group faced a significant dropped in their hemoglobin and hematocrit; however, the decrement was significant lower in case group. In addition, both groups had a stable hemostasis after 1h and 6h of surgery. In this regard, we did not observe any significant difference between heart rate and blood pressure of two groups. Conclusion: The results of this study suggest that using epinephrine as vasoconstriction agent in tumescent solution might decrease the rate of bleeding and increase the chance of stable hemostasis both during and after abdominal liposuction.

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Section: Discussionmentioning

confidence: 48%

Comparative evaluation about the efficacy of the use of variable concentrations of Epinephrine in Tumescent solution for control of bleeding in patients with abdominal liposuction

Farhadi

Khorshidifar

Ghalambor

et al. 2020

J. Contemp. Med. Sci.

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“…In our review, 23 studies assessed the use of TXA in various aesthetic or breast-related procedures [48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64]. [57,59,60], and one was a case series [52]. Study sample ranged from 20 to 304 patients, apart from a single cohort study of 750 septo-rhinoplasty patients [57].…”

Section: Aesthetic Surgery/breast Surgerymentioning

confidence: 99%

“…[57,59,60], and one was a case series [52]. Study sample ranged from 20 to 304 patients, apart from a single cohort study of 750 septo-rhinoplasty patients [57].…”

Section: Aesthetic Surgery/breast Surgerymentioning

confidence: 99%

“…Regarding oral administration, Eftekharian HR et al reported use of a single preoperative dose of 1 g orally, while Sakallioğlu Ö et al used a preoperative dose of 1 g, followed by an eight-hourly dose regimen of 1 g orally for 5 days. For topical/local administration, four studies reported topical administration either using soaked pledgets (undefined dosage) [52], soaked sponge tampons (undefined dosage) [57], or wound moistening with a 25 mg/ml TXA-saline solution [49,58]. In addition, three studies reported adding TXA to tumescent solution or local anesthetic solution [50,59,62].…”

Section: Aesthetic Surgery/breast Surgerymentioning

confidence: 99%

“…Meanwhile, Schroeder RJ et al (topical and local TXA) and Zilinsky I et al (local TXA) reported beneficial effect of mixing TXA with local anesthetic solution, resulting in decreased drain output and better subjective assessment of hemostasis, respectively [59,62]. Ors S et al reported positive outcomes in 15 cases of postoperative bleeding following a septo-rhinoplasty using 3-day packing with polyvinyl alcohol tampons soaked in adrenaline and tranexamic acid, along with a single intravenous dose of 250 mg of tranexamic acid [57].…”

Section: Aesthetic Surgery/breast Surgerymentioning

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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