Magni Sara, Guggenheim Leon, Fournier Geraldine, Parodi Corrado, Pagnamenta Alberto, Schmauss Daniel, Harder Yves
Department of Plastic, Reconstructive and Aesthetic Surgery, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), 6900 Lugano, Switzerland.
Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland.
J Clin Med. 2024 Dec 30;14(1):151. doi: 10.3390/jcm14010151.
Reduction mammaplasty is a common, elective, and safe operation, usually executed in healthy patients. Nonetheless, postoperative complications like bleeding and seroma formation can occur and significantly complicate the postoperative course. Tranexamic acid (TXA), a commonly used antifibrinolytic drug, offers a novel approach to reduce these complications. This study aims to evaluate its effect on the rate of postoperative bleeding, drainage volume, length of hospital stay, and other postoperative complications in patients undergoing reduction mammaplasty. A retrospective study on all patients undergoing reduction mammaplasty at the Department of Plastic, Reconstructive, and Aesthetic Surgery EOC between 2015 and 2022 was conducted. Patients were divided into the TXA group receiving systemic TXA for 48 h and the control group not receiving any TXA. All data were analyzed using nonparametric formulas. A total of 209 breasts were included in the study, with 138 cases in the control group and 71 in the TXA group. Three cases requiring revision surgery due to bleeding were observed in the control group, whereas none were observed in the TXA group. Total drainage volume was significantly reduced in the TXA group compared to the control group (TXA: 41.6 mL vs. control: 53.8 mL; = 0.012), resulting in a significant reduction in length of hospital stay (TXA: 1.6 days vs. control: 2.2 days; = 0.0001). TXA is a well-tolerated drug that significantly reduces postoperative bleeding and drainage volume, resulting in earlier drain removal and reduced length of hospital stay. TXA should, therefore, be widely used in plastic surgery, especially as trends in healthcare systems necessitate more outpatient procedures and quicker postoperative recovery.
缩乳术是一种常见的择期安全手术，通常在健康患者中进行。尽管如此，术后仍可能出现出血和血清肿形成等并发症，使术后恢复过程显著复杂化。氨甲环酸（TXA）是一种常用的抗纤溶药物，为减少这些并发症提供了一种新方法。本研究旨在评估其对接受缩乳术患者术后出血率、引流量、住院时间和其他术后并发症的影响。对2015年至2022年期间在EOC整形、重建和美容外科接受缩乳术的所有患者进行了一项回顾性研究。患者分为接受全身性TXA治疗48小时的TXA组和未接受任何TXA的对照组。所有数据均使用非参数公式进行分析。该研究共纳入209个乳房，其中对照组138例，TXA组71例。对照组观察到3例因出血需要进行修复手术，而TXA组未观察到。与对照组相比，TXA组的总引流量显著减少（TXA组：41.6 mL，对照组：53.8 mL；P = 0.012），住院时间也显著缩短（TXA组：1.6天，对照组：2.2天；P = 0.0001）。TXA是一种耐受性良好的药物，可显著减少术后出血和引流量，从而提前拔除引流管并缩短住院时间。因此，TXA应在整形手术中广泛应用，尤其是随着医疗保健系统的趋势要求更多的门诊手术和更快的术后恢复。
