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Fleur-de-lis 腹部整形和裙边切除术应用氨甲环酸减少术后失血和出血并发症。

Systemic Tranexamic Acid for Reduced Postoperative Blood Loss and Less Bleeding Complications in Fleur-de-lis Abdominoplasty and Apronectomy.

机构信息

Department of Plastic and Aesthetic Surgery, Reconstructive and Hand Surgery, Agaplesion Markus Hospital, Wilhelm-Epstein-Straße 4, 60431, Frankfurt am Main, Germany.

Department of Plastic, Reconstructive and Aesthetic Surgery, Diakonie Hospital, Bad Kreuznach, Germany.

出版信息

Aesthetic Plast Surg. 2024 Jul;48(13):2465-2474. doi: 10.1007/s00266-024-03992-5. Epub 2024 Mar 28.

Abstract

BACKGROUND

Strategies minimizing surgical bleeding, including the antifibrinolytic agent tranexamic acid, play a crucial role in clinical practice to optimize overall surgical outcomes. Despite its proven efficacy in various clinical fields, there is a limited understanding regarding the use of tranexamic acid in plastic and aesthetic procedures. This study is the first investigating the effects of systemically administered tranexamic acid on postoperative blood loss and bleeding complications in fleur-de-lis abdominoplasties and apronectomies.

METHODS

Patients who received 1 g tranexamic acid (n = 44) during fleur-de-lis abdominoplasty or apronectomy were retrospectively compared with those who did not (n = 44). In this context, the outcome parameters 24-h and total drain fluid production, drain time, hospital stay, absolute and relative drop in hemoglobin and hematocrit level as well as bleeding complications such as blood transfusion, hematoma puncture and evacuation were evaluated.

RESULTS

Tranexamic acid significantly decreased both drainage volume in 24 h (40.5%, p = 0.0046) and total drain fluid production (42.5%, p = 0.0017). Moreover, a shorter drainage time (19.4%, p = 0.0028) and hospital stay (21.4%, p = 0.0009) were observed. The administration of tranexamic acid was also associated with a reduced postoperative decline in hemoglobin and hematocrit levels. Notably, no bleeding complications were observed in patients who received tranexamic acid, while 6 events occurred in patients without (p = 0.0262).

CONCLUSION

Systemic administration of tranexamic acid effectively reduced postoperative blood loss and bleeding complications in fleur-de-lis abdominoplasties and apronectomies.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

摘要

背景

包括氨甲环酸在内的旨在减少手术出血的策略在临床实践中起着至关重要的作用,以优化整体手术效果。尽管氨甲环酸已在多个临床领域得到证实有效,但对于其在整形和美容手术中的应用,人们的了解仍有限。本研究首次调查了全身性给予氨甲环酸对 Fleur-de-lis 腹部整形术和前腹部成形术术后失血和出血并发症的影响。

方法

回顾性比较了在 Fleur-de-lis 腹部整形术或前腹部成形术中接受 1g 氨甲环酸(n=44)的患者与未接受氨甲环酸的患者(n=44)。在此背景下,评估了 24 小时和总引流液产生、引流时间、住院时间、血红蛋白和血细胞比容水平的绝对和相对下降以及输血、血肿穿刺和清除等出血并发症等结局参数。

结果

氨甲环酸显著减少了 24 小时内的引流量(40.5%,p=0.0046)和总引流液产生量(42.5%,p=0.0017)。此外,引流时间(19.4%,p=0.0028)和住院时间(21.4%,p=0.0009)也有所缩短。氨甲环酸的给药还与血红蛋白和血细胞比容水平术后下降减少相关。值得注意的是,接受氨甲环酸治疗的患者中未观察到出血并发症,而未接受氨甲环酸治疗的患者中有 6 例发生(p=0.0262)。

结论

全身性给予氨甲环酸可有效减少 Fleur-de-lis 腹部整形术和前腹部成形术中的术后失血和出血并发症。

证据等级 IV:本杂志要求作者为每篇文章分配一个证据等级。有关这些循证医学等级的完整描述,请参考目录或在线作者指南 www.springer.com/00266

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