Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA.
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
Aesthet Surg J. 2022 Aug 24;42(9):971-977. doi: 10.1093/asj/sjac067.
Tranexamic acid (TXA) has rapidly gained popularity in aesthetic surgery. Previous reports have suggested that TXA provides a dry surgical field and significantly reduces operating time during facelift surgery.
The aim of this study was to build upon earlier findings by providing a large cohort matched alongside historic controls and more clearly document time saved when performing facelift surgery.
A retrospective, single-surgeon case-control study was undertaken between July 2016 and October 2021. All patients underwent facelift surgery alone or in combination with fat transfer and perioral chemical peel. All patients received subcutaneous infiltration of 0.5% lidocaine/1:200,000 epinephrine with or without 1 or 2 mg/mL TXA. Patient demographics, TXA dose, surgical time, and minor and major complications were examined.
In total 145 consecutive patients were identified: 73 in Group 1 (no-TXA) and 72 in Group 2 (TXA). No differences in terms of gender distribution (P = 0.75), age (P = 0.54), BMI (P = 0.18), frequency of secondary rhytidectomy (P = 0.08), rate of ancillary lipografting (P = 0.44), TXA dose (P = 0.238), and minor complication rate (P = 0.56) were observed. However, mean surgical time in the no-TXA group was 21 minutes longer than in the TXA group (P = 0.016). Six patients (8%) in the no-TXA group experienced minor complications vs 8 patients (11%) in the TXA group. No patients experienced major complications.
Although previous studies have highlighted the potential benefits of TXA in aesthetic surgery, most of the data remain subjective and non-validated. This report adds to the objective body of evidence supporting TXA in facial aesthetic surgery by documenting time saved in the operating room without additional surgical morbidity.
氨甲环酸（TXA）在美容外科中迅速流行。先前的报告表明，TXA 提供了一个干燥的手术场，并显著缩短了面部提升手术的操作时间。
本研究旨在在前人的基础上进一步研究，提供一个大的队列与历史对照匹配，并更清楚地记录在进行面部提升手术时节省的时间。
回顾性、单外科医生病例对照研究于 2016 年 7 月至 2021 年 10 月进行。所有患者均单独接受面部提升手术或与脂肪转移和口周化学剥脱联合进行。所有患者均接受 0.5%利多卡因/1:200000 肾上腺素皮下浸润，或加用或不加用 1 或 2mg/mL 的 TXA。检查患者的人口统计学资料、TXA 剂量、手术时间以及轻微和严重并发症。
共确定了 145 例连续患者：73 例在第 1 组（无-TXA），72 例在第 2 组（TXA）。在性别分布方面无差异（P = 0.75）、年龄（P = 0.54）、BMI（P = 0.18）、二次除皱术频率（P = 0.08）、辅助脂肪移植率（P = 0.44）、TXA 剂量（P = 0.238）和轻微并发症发生率（P = 0.56）方面均无差异。然而，无-TXA 组的平均手术时间比 TXA 组长 21 分钟（P = 0.016）。无-TXA 组 6 例（8%）患者发生轻微并发症，TXA 组 8 例（11%）患者发生轻微并发症。无患者发生严重并发症。
尽管先前的研究强调了 TXA 在美容外科中的潜在益处，但大多数数据仍然是主观的和未经验证的。本报告通过记录在手术室节省的时间，而不增加手术发病率，为支持 TXA 在面部美容手术中的应用提供了客观的证据。
