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Effect of Local Tranexamic Acid on Hemostasis in Rhytidectomy.

Ronald J Schroeder1, Phillip R Langsdon1,2

  • 1Department of Otolaryngology, Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.

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Local tranexamic acid (TXA) significantly reduces bleeding and drain output in rhytidectomy procedures. This antifibrinolytic agent improves patient recovery by decreasing blood loss and shortening drain removal times.

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Area of Science:

  • Plastic Surgery
  • Surgical Complications
  • Pharmacology

Background:

  • Hematoma is the most frequent complication following rhytidectomy.
  • Tranexamic acid (TXA), an antifibrinolytic agent, shows potential in mitigating surgical bleeding and reducing hematoma risk.

Purpose of the Study:

  • To evaluate the efficacy of local tranexamic acid (TXA) in reducing intraoperative bleeding and postoperative drain output during rhytidectomy.

Main Methods:

  • A retrospective cohort study compared patients undergoing deep plane rhytidectomy with platysmaplasty.
  • The TXA group received 100 mg of TXA mixed with local anesthetic and tumescent solution, while the control group did not.
  • Outcomes measured included postoperative day 1 drain output, time to drain removal, and intraoperative estimated blood loss (EBL).

Main Results:

  • TXA significantly reduced postoperative day 1 drain output (14.8 cc vs. 50.4 cc) and shortened the average time to drain removal (1.2 days vs. 1.8 days).
  • The percentage of drains removed on postoperative day 1 increased substantially with TXA use (77.3% vs. 34.4%).
  • Intraoperative EBL less than 50 cc increased from 25% in the control group to 75% in the TXA group (p < 0.001).

Conclusions:

  • Local TXA administration in rhytidectomy effectively decreases intraoperative blood loss and postoperative drain fluid accumulation.
  • The use of TXA leads to a faster return to baseline, evidenced by reduced drain output and earlier drain removal.
  • No significant increase in hematoma or thromboembolic events was observed with the local use of TXA.