Plastic Surgery Unit, Hillel Yaffe Medical Center, P.O.B 169, 38100, Hadera, Israel.
Aesthetic Plast Surg. 2023 Dec;47(6):2525-2532. doi: 10.1007/s00266-023-03499-5. Epub 2023 Jul 24.
Hematomas are common complications following plastic and esthetic surgeries. Large and complex hematomas might result in prolonged hospitalization, further interventions, additional expenses, and poor esthetic outcome. Tranexamic acid (TXA), an antifibrinolytic agent, has long been used to reduce blood loss. Its use in the field of plastic surgery has gained popularity recently. Several studies have presented the ability of TXA to reduce blood loss, hematomas, and ecchymoses after liposuctions. However, the proper dose and the route of administration remained controversial.
The objective of the study was to quantify the effect of a low dose of TXA in an irrigation method in reducing hematomas and ecchymoses following liposuction.
A prospective randomized controlled trial was conducted. Following liposuction, 400 mg of TXA were administered in an irrigation protocol to one side of the body in each patient, while the other side was administered with saline. The patients were photographed on 1, 2, 4, and 11 post-operative days. Ecchymosis and hematoma were measured and rated.
No statistical difference was observed between the intervention and control groups in terms of RBC in liposuction area (p = 0.11), RBC in lipoaspirate (p = 0.79), bruising size on days 1, 2, 4, and 11 (p = 0.68, 0.21, 0.42, and 0.75), and average ecchymosis score on the same days (p = 0.34, 0.72, 0.09, and 1) CONCLUSIONS: The use of a low-dose TXA irrigation solution did not demonstrate a statistically significant difference in post-operative hematoma formations rates and subsequent ecchymosis size and scale.
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血肿是整形和美容手术后常见的并发症。大而复杂的血肿可能导致住院时间延长、进一步干预、额外费用和美容效果不佳。氨甲环酸（TXA）是一种抗纤维蛋白溶解剂，长期以来一直用于减少失血。最近，它在整形手术领域的应用越来越受欢迎。几项研究表明，TXA 能够减少抽脂术后的失血、血肿和瘀斑。然而，合适的剂量和给药途径仍存在争议。
本研究旨在定量评估低剂量 TXA 灌洗在减少抽脂术后血肿和瘀斑中的作用。
进行了一项前瞻性随机对照试验。在抽脂术后，每位患者的一侧身体用 TXA 400mg 进行灌洗方案给药，另一侧用生理盐水给药。患者在术后 1、2、4 和 11 天拍照。测量并评估瘀斑和血肿。
在抽脂区 RBC（红细胞）（p=0.11）、吸脂中 RBC（p=0.79）、术后第 1、2、4 和 11 天瘀斑大小（p=0.68、0.21、0.42 和 0.75）和同一时间平均瘀斑评分（p=0.34、0.72、0.09 和 1）方面，干预组与对照组之间均未观察到统计学差异。
使用低剂量 TXA 灌洗液在术后血肿形成率以及随后的瘀斑大小和程度方面未显示出统计学显著差异。
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