Abumelha Abdulaziz F, Halawani Ibrahim R, Abu Alqam Rakan, Alali Feryal Khalid, Alsubhi Razan Omar, AlMosained Haya, Alkhwildi Lama A, Albalawi Ibrahim Abdullah S, Alsuhaim Abdulaziz, Al Mashhrawi Yousef M, Bafail Anas, Alohaideb Nawaf
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia.
Aesthetic Plast Surg. 2025 Feb;49(4):1109-1119. doi: 10.1007/s00266-024-04517-w. Epub 2024 Nov 18.
Liposuction has become the most sought-after aesthetic surgery across the globe, increasing the demand for more developments in patient safety protocols. Evidence of the efficacy of tranexamic acid (TXA) in reducing intraoperative blood loss with minimal complications have led to its widespread applications across various surgical operations. However, the role and effectiveness of TXA in liposuction is not fully understood. Therefore, the purpose of this systematic review and meta-analysis is to investigate the effectiveness of TXA in minimizing intraoperative blood loss in patients undergoing liposuction.
In adherence to the preferred reporting items for systematic reviews and meta-analysis guidelines, a comprehensive search was conducted in multiple databases including, PubMed, Cochrane CENTRAL, and Web of Science. Only randomized controlled trials (RCTs) were included without time frame limitations. Our primary outcomes were hemoglobin levels, hematocrit levels, lipoaspirate volume, and associated complications.
This meta-analysis provides a comprehensive analysis of five RCTs published between 2021-2023, involving 334 patients. The pooled mean difference for postoperative hemoglobin levels was statistically significant in favor of local TXA administration (MD 0.54; P = 0.03; I= 0%). Analysis of postoperative hematocrit levels (g/dL) and lipoaspirate volume (L) mean differences were statistically insignificant (MD 0.76; P = 0.35; I= 0%) and (MD 0.19; P = 0.82; I= 85%) respectively. No complications related to the use of TXA occurred.
Although a statistically significant difference was seen in postoperative hemoglobin levels, it is imperative that the results are interpreted with caution, given the preliminary nature of the observed effect. Further large well-designed RCTs are required to solidify current TXA protocols and to provide comprehensive guidelines for its application in liposuction.
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抽脂术已成为全球最受欢迎的美容手术，这增加了对患者安全协议进一步发展的需求。氨甲环酸（TXA）在减少术中失血且并发症极少方面的疗效证据，已使其在各种外科手术中得到广泛应用。然而，TXA在抽脂术中的作用和效果尚未完全明确。因此，本系统评价和荟萃分析的目的是研究TXA在减少抽脂术患者术中失血方面的有效性。
按照系统评价和荟萃分析指南的首选报告项目，在多个数据库中进行了全面检索，包括PubMed、Cochrane CENTRAL和科学网。仅纳入无时间框架限制的随机对照试验（RCT）。我们的主要结局指标是血红蛋白水平、血细胞比容水平、抽脂量和相关并发症。
本荟萃分析对2021年至2023年发表的五项RCT进行了全面分析，涉及334例患者。术后血红蛋白水平的合并平均差在统计学上有显著差异，支持局部使用TXA（MD 0.54；P = 0.03；I = 0%）。术后血细胞比容水平（g/dL）和抽脂量（L）平均差的分析在统计学上无显著差异，分别为（MD 0.76；P = 0.35；I = 0%）和（MD 0.19；P = 0.82；I = 85%）。未发生与使用TXA相关的并发症。
尽管术后血红蛋白水平存在统计学上的显著差异，但鉴于观察到的效果具有初步性质，对结果的解释仍需谨慎。需要进一步开展大规模、设计良好的RCT，以巩固当前的TXA方案，并为其在抽脂术中的应用提供全面指南。
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