Defining the Role for Topically Administered Tranexamic Acid in Panniculectomy Surgery.

Area of Science:

• Plastic Surgery
• Surgical Outcomes
• Patient Safety

Background:

• Abdominal panniculectomy is common post-weight loss, with high satisfaction but frequent complications.
• Risk-reducing techniques exist, but tranexamic acid (TXA) use in panniculectomy is unstudied.

Purpose of the Study:

• To evaluate if topical TXA reduces seroma, hematoma, and drain duration in panniculectomy.
• To improve the safety and predictability of panniculectomy surgery.

Main Methods:

• Retrospective review of 288 panniculectomy patients (Jan 2010-Jan 2022).
• Compared outcomes (seroma, hematoma, drain duration) between patients receiving topical TXA and a historical control group.
• Excluded patients with thromboembolic disease or on anticoagulation/antiplatelet medications.

Main Results:

• TXA use was not associated with a statistically significant reduction in seroma (OR=1.7) or hematoma (OR=2.1).
• Mean drain duration was slightly lower with TXA (18.1 days vs. 19.8 days), but this difference was not statistically significant.
• Follow-up averaged 3.7 years, with a median resection weight of 2.6 kg.

Conclusions:

• Topical TXA did not significantly reduce seroma, hematoma, or drain duration in this panniculectomy cohort.
• The utility of TXA in body contouring procedures like panniculectomy requires further investigation.
• Prospective, randomized controlled trials are recommended to clarify TXA's role.