From the Department of Otolaryngology-Head and Neck Surgery, Bingol State Hospital.
Department of Otolaryngology-Head and Neck Surgery, Baskent University Faculty of Medicine.
Plast Reconstr Surg. 2024 Mar 1;153(3):609-617. doi: 10.1097/PRS.0000000000010631. Epub 2023 May 9.
This study aimed to examine the effectiveness of topical tranexamic acid application in overcoming periorbital ecchymosis and eyelid edema in patients who have undergone open-technique rhinoplasty.
Fifty patients were included in the study and divided into two groups: those who had topical tranexamic acid applied and those who did not (controls). In the tranexamic acid group, tranexamic acid-soaked pledgets were placed under the skin flap in a way that both sides could reach the osteotomy area and left for 5 minutes. In the control group, isotonic saline-soaked pledgets were placed under the skin flap in the same manner and left for 5 minutes. Digital photographs were obtained on postoperative days 1, 3, and 7. Eyelid edema and periorbital ecchymosis were scored by two different examiners and averaged for comparison.
Edema that developed in the patients who had tranexamic acid applied was significantly less than in the control group on postoperative day 1. There was no difference between the two groups on postoperative day 3 or 7. Ecchymosis that developed in patients who had tranexamic acid applied was significantly less than in the control group on all days.
Topical tranexamic acid applied to the surgical field immediately after osteotomy in rhinoplasty surgery reduces the development of postoperative periorbital ecchymosis. In addition, the topical tranexamic acid application also reduces the development of eyelid edema in the early postoperative period.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
本研究旨在探讨在接受开放式鼻整形术的患者中，局部应用氨甲环酸是否能有效减轻眶周瘀斑和眼睑肿胀。
本研究纳入了 50 名患者，并将其分为两组：一组使用氨甲环酸治疗（实验组），另一组使用等渗盐水治疗（对照组）。实验组中，将氨甲环酸浸湿的棉片置于皮瓣下，使两侧均能到达骨切开区域，并保留 5 分钟。对照组中，将等渗盐水浸湿的棉片置于皮瓣下，方法相同，保留 5 分钟。术后第 1、3、7 天拍摄数码照片。由两名不同的检查者对眼睑肿胀和眶周瘀斑进行评分，并取平均值进行比较。
实验组患者术后第 1 天出现的肿胀明显少于对照组。术后第 3 天和第 7 天，两组之间无差异。实验组患者术后第 1 天出现的瘀斑明显少于对照组。
在鼻整形术中，骨切开后立即在手术区域应用氨甲环酸可减少术后眶周瘀斑的形成。此外，局部应用氨甲环酸还可减少术后早期眼睑肿胀的发生。
临床问题/证据水平：治疗性，II 级。
