Alhebshi Zainah Abdulbari, Sabbagh Sham Radwan, AlQurain Zainab Jasim, Bamuqabel Aya Omar, Dahlan Dana Jamal, Rajoub Rawan Abdulmuati, Fallatah Danah Osama, Rajoub Banan Abdulmuati, Wasaya Hanan Muhammed Ismail, Fallatah Ezdehar
Aesthet Surg J Open Forum. 2025 May 3;7:ojaf035. doi: 10.1093/asjof/ojaf035. eCollection 2025.
Reduction mammoplasty (RM) decreases breast size but may lead to complications such as hematoma. Local tranexamic acid (TXA) is applied during surgery to minimize bleeding during or after the procedure. This systematic review, conducted in August 2024 using PubMed, Ovid Medline, and Ovid Embase, assessed the impact of local TXA on RM. The Methodological Index for Nonrandomized Studies and the Revised Cochrane risk of bias (RoB2) tools were employed to assess the risk of bias. Data analysis was performed using RevMan software. In this meta-analysis of 5 studies involving 608 patients (1216 breasts) undergoing RM, 46.8% of breasts were treated with TXA. Local TXA significantly reduced the 24-h drain output (mean difference -11.49, 95% CI, -15.71, -7.26; < .00001). Higher TXA concentrations (20 and 25 mg/mL) significantly reduced hematoma rates (odds ratio [OR] 0.09, 95% CI, 0.03, 0.30; < .0001), whereas lower concentrations showed no similar effect. TXA also reduced the complication rates in RM (OR 0.63, 95% CI, 0.50, 0.80; = .0002), although its impact on drain utilization, duration, and seroma rates was not statistically significant. Local TXA showed promising results, because it reduced the 24 h drain output, overall occurrence of postoperative complications, and when used in higher concentrations, decreased the hematoma formation. However, we need further randomized controlled trials to confirm the efficacy of different concentrations of TXA in RM. 3 (Therapeutic).
缩乳术（RM）可减小乳房尺寸，但可能会导致血肿等并发症。手术过程中应用局部氨甲环酸（TXA）以尽量减少手术期间或术后的出血。本系统评价于2024年8月使用PubMed、Ovid Medline和Ovid Embase进行，评估了局部TXA对缩乳术的影响。采用非随机研究方法学指数和修订后的Cochrane偏倚风险（RoB2）工具评估偏倚风险。使用RevMan软件进行数据分析。在这项对5项研究的荟萃分析中，涉及608例接受缩乳术的患者（1216侧乳房），46.8%的乳房接受了TXA治疗。局部TXA显著减少了24小时引流量（平均差值-11.49，95%CI，-15.71，-7.26；P<.00001）。较高浓度的TXA（20和25mg/mL）显著降低了血肿发生率（优势比[OR]0.09，95%CI，0.03，0.30；P<.0001），而较低浓度则未显示出类似效果。TXA还降低了缩乳术的并发症发生率（OR 0.63，95%CI，0.50，0.80；P=.0002），尽管其对引流使用、持续时间和血清肿发生率的影响无统计学意义。局部TXA显示出有前景的结果，因为它减少了24小时引流量、术后并发症的总体发生率，并且当以较高浓度使用时，降低了血肿形成。然而，我们需要进一步的随机对照试验来证实不同浓度的TXA在缩乳术中的疗效。3（治疗性）
