Local infiltration of tranexamic acid during tissue expander insertion reduces postoperative drainage: A retrospective matched study.

BACKGROUND

Tranexamic acid (TXA) has gained increasing recognition for its efficacy in minimizing blood loss, ecchymosis, and edema.

METHODS

This study investigates whether local infiltration of TXA during tissue expander insertion safely reduces postoperative drainage. A single-surgeon retrospective cohort study was performed to analyze patients undergoing tissue expander insertion between 2021 and 2023. Following expander insertion, patients in the intervention group received 5 mL of TXA (0.25 g in NaCl 0.9 %) infiltrated into the dissection area, whereas the historical controls did not. Patient demographics, drainage volume and duration, surgical complications, and adverse events were examined. The impact of various factors on the drainage volume and duration was evaluated by multiple linear regression analysis. Using inverse probability weighting (IPW), a statistical method that applies weights to account for confounding factors in observational studies, the drainage volume and duration between the two groups were compared.

RESULTS

A total of 127 expander insertion procedures were reviewed, with 42 receiving TXA and 85 not. Complications were similar between the groups, and no severe adverse effects of TXA were observed. Regression analysis indicated that the use of TXA and limb location were negatively correlated with postoperative drainage duration and drainage volume unit area of the first postoperative day. Due to the imbalance in the layer of expander insertion between the two groups, IPW was applied. After IPW, the TXA group had significantly reduced drainage duration (P = 0.002) and drainage volume on the first postoperative day (P = 0.008) compared to the no-TXA group.

CONCLUSIONS

Local infiltration of TXA during expander insertion is associated with reduced drainage.