Ziegler Rodríguez Otto Rolando, De la Cruz Ku Gabriel, Chávez Díaz Marcelo, Ziegler Rodríguez Gonzalo Javier, Ziegler Gutiérrez Otto Enrique
From the Department of Aesthetic, Plastic and Reconstructive Surgery, Clínica Ziegler, Lima, Peru.
Universidad Peruana de Ciencias Aplicadas Lima, Peru.
Plast Reconstr Surg Glob Open. 2024 Mar 8;12(3):e5653. doi: 10.1097/GOX.0000000000005653. eCollection 2024 Mar.
Tranexamic acid (TXA) has demonstrated promising outcomes in plastic surgery. Our aim was to assess the effect of TXA in intraoperative bleeding, operative time, and complications among patients undergoing facial surgical procedures.
A retrospective cohort study of patients who underwent multiplane facial rhytidectomy from January 2018 to September 2022 at the Clinica Ziegler, Lima, Peru. Patients were divided into two groups according to the use of intravenous plus local infiltration of TXA. We performed the chi square test to assess associations among categorical variables, the Student test and Mann-Whitney U test for categorical with continuous variables, and Pearson correlation for quantitative variables.
A total of 100 patients were included with 50 patients in each group. The median age was 59.5 years and the majority were women (88%). The median operative time was 288.5 minutes. The TXA group presented less intraoperative bleeding (40 versus 90 mL, < 0.05) and shorter operative time (237 versus 353 minutes, < 0.05); no differences in the development of hematoma (2% versus 12%, = 0.11), less ecchymosis (2% versus 36%, < 0.05), edema (2% versus 100%, < 0.05), and time to drain removal (3 versus 6 days, < 0.05).
TXA improves the short- and long-term outcomes of patients who undergo multiplane facial rhytidectomy. It also decreases intraoperative bleeding by more than half and reduces the operative time by one third. Moreover, patients receiving TXA presented significantly less ecchymosis, edema, and time to drain removal.
氨甲环酸（TXA）在整形手术中已显示出有前景的结果。我们的目的是评估TXA对接受面部外科手术患者术中出血、手术时间和并发症的影响。
对2018年1月至2022年9月在秘鲁利马齐格勒诊所接受多平面面部除皱术的患者进行回顾性队列研究。根据是否使用静脉加局部浸润TXA将患者分为两组。我们进行卡方检验以评估分类变量之间的关联，对分类变量与连续变量进行学生检验和曼-惠特尼U检验，对定量变量进行皮尔逊相关性分析。
共纳入100例患者，每组50例。中位年龄为59.5岁，大多数为女性（88%）。中位手术时间为288.5分钟。TXA组术中出血较少（40对90毫升，P<0.05），手术时间较短（237对353分钟，P<0.05）；血肿发生情况无差异（2%对12%，P = 0.11），瘀斑较少（2%对36%，P<0.05），水肿较少（2%对100%，P<0.05），引流管拔除时间较短（3对6天，P<0.05）。
TXA改善了接受多平面面部除皱术患者的短期和长期结局。它还使术中出血减少一半以上，手术时间缩短三分之一。此外，接受TXA的患者瘀斑、水肿和引流管拔除时间明显减少。
