Meretsky Christopher R, Polychronis Andreas, Schiuma Anthony T
Surgery, St. George's University School of Medicine, New York, USA.
General Surgery, St. George's University School of Medicine, New York, USA.
Cureus. 2024 Jun 16;16(6):e62482. doi: 10.7759/cureus.62482. eCollection 2024 Jun.
With increasing interest in aesthetic plastic procedures, the event of blood loss has compromised patients' safety and satisfaction. Tranexamic acid (TXA) is a drug used for the reduction of blood loss during surgical procedures. This systematic review aims to evaluate the clinical efficacy and safety of TXA in aesthetic plastic surgery for the reduction of bleeding and related complications. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Electronic databases PubMed, EMBASE, Cochrane Library, and Google Scholar were searched. The medical subject headings (MeSH) keywords used for data extraction were ("TXA," OR "tranexamic acid,") AND ("plastic surgery," OR "aesthetic surgery," OR "rhinoplasty," OR "blepharoplasty,") AND ("blood loss" OR "bleeding" OR "TBL") AND ("Edema" OR "ecchymosis"). A combination of these MeSH terms was used in the literature search. The timeline of research was set from 2015 to January 2024. A total of 7380 research articles were identified from the above-mentioned databases, and only 13 research articles met the inclusion criteria. There was a significant difference in total blood loss (TBL) among patients who had undergone plastic surgery procedures while on TXA as compared to a placebo (mean difference = -6.02; Cl: -1.07 to -0.16; p > 0.00001), and heterogeneity was found (degrees of freedom (df) = 9; I2 = 97%). Only two studies reported the average ecchymosis scores after TXA among interventions in comparison to the placebo group. This review provides evidence that TXA lowers TBL, ecchymosis, edema, and anemia during cosmetic surgery without significantly increasing thromboembolic consequences.
随着人们对美容整形手术的兴趣日益增加，失血情况已对患者的安全和满意度造成影响。氨甲环酸（TXA）是一种用于减少外科手术中失血的药物。本系统评价旨在评估TXA在美容整形手术中减少出血及相关并发症的临床疗效和安全性。遵循了系统评价和Meta分析的首选报告项目（PRISMA）指南。检索了电子数据库PubMed、EMBASE、Cochrane图书馆和谷歌学术。用于数据提取的医学主题词（MeSH）关键词为（“TXA”或“氨甲环酸”）与（“整形手术”或“美容手术”或“隆鼻术”或“眼睑成形术”）与（“失血”或“出血”或“总失血量”）与（“水肿”或“瘀斑”）。在文献检索中使用了这些MeSH术语的组合。研究时间范围设定为2015年至2024年1月。从上述数据库中总共识别出7380篇研究文章，只有13篇研究文章符合纳入标准。与安慰剂相比，接受整形手术时使用TXA的患者总失血量（TBL）存在显著差异（平均差异=-6.02；可信区间：-1.07至-0.16；p>0.00001），并且发现存在异质性（自由度（df）=9；I²=97%）。与安慰剂组相比，只有两项研究报告了TXA干预后平均瘀斑评分。本评价提供的证据表明，TXA在整容手术中可降低TBL、瘀斑、水肿和贫血，且不会显著增加血栓栓塞后果。
