Chen Teresa H, Fujimoto Dylann, Feijó Eduardo Damous, Rios Jose Eduardo, de Figueiredo Rassi Marisa Novaes, Leão Rafael, Tao Jeremiah P, Limongi Roberto Murillo
Aesthet Surg J. 2025 May 15;45(6):563-567. doi: 10.1093/asj/sjaf036.
Tranexamic acid (TXA) is an antifibrinolytic that is regularly used to reduce bleeding in surgical specialties.
The objective of this study was to assess the effects of subcutaneous TXA in oculofacial plastic surgeries, with the hypothesis that TXA reduced postoperative ecchymosis and edema.
This was a prospective, randomized, double-blind, split-face study. The sides of the face were randomized to local anesthetic (bupivacaine with epinephrine) mixed with TXA or sodium chloride (placebo). Photographs were taken immediately postoperatively and on postoperative day (POD) 7. Photographs were graded by 2 masked investigators with the Surgeon Periorbital Rating of Edema and Ecchymosis criteria. Patients selected the side that they subjectively determined to have less ecchymosis and edema. As a secondary outcome, patients rated pain on each side of their face with the Wong-Baker FACES pain scale.
Twenty-four patients undergoing bilateral, symmetric oculofacial surgery were included in the study. There was a statistically significant difference in postoperative periocular ecchymosis on POD7 (with TXA .91 ± 0.73 vs placebo 1.61 ± 1.03; P = .020) and in periocular edema on POD1 (with TXA 1.30 ± 0.76 vs placebo 2.00 ± 0.85; P = .028). All patients selected the side of the face receiving TXA as having less periocular ecchymosis and edema. There was no statistically significant difference in subjective pain level between the side receiving TXA vs placebo. There were no intraoperative or postoperative complications.
Subcutaneous TXA was safe and reduced periocular ecchymosis and edema compared to contralateral placebo injections in this series of patients undergoing bilateral oculofacial plastic surgeries.
氨甲环酸（TXA）是一种抗纤维蛋白溶解剂，常用于减少外科手术中的出血。
本研究的目的是评估皮下注射TXA在眼面部整形手术中的效果，假设TXA可减少术后瘀斑和水肿。
这是一项前瞻性、随机、双盲、半脸对照研究。面部两侧随机分配接受与TXA混合的局部麻醉剂（含肾上腺素的布比卡因）或氯化钠（安慰剂）。术后即刻及术后第7天拍摄照片。由2名盲法研究者根据外科医生眶周水肿和瘀斑评分标准对照片进行评分。患者选择他们主观认为瘀斑和水肿较少的一侧。作为次要结果，患者使用面部表情疼痛量表对其面部两侧的疼痛进行评分。
24例接受双侧对称眼面部手术的患者纳入研究。术后第7天，术眼周围瘀斑存在统计学显著差异（TXA组0.91±0.73，安慰剂组1.61±1.03；P = 0.020），术后第1天术眼周围水肿存在统计学显著差异（TXA组1.30±0.76，安慰剂组2.00±0.85；P = 0.028）。所有患者均选择接受TXA治疗的一侧面部术眼周围瘀斑和水肿较少。接受TXA治疗的一侧与接受安慰剂治疗的一侧在主观疼痛水平上无统计学显著差异。无术中或术后并发症。
在这一系列接受双侧眼面部整形手术的患者中，皮下注射TXA与对侧注射安慰剂相比是安全的，且可减少术眼周围瘀斑和水肿。
