Impact of Tranexamic Acid on Bleeding Outcomes and Complication Rates in Facelift: A Systematic Review and...

Area of Science:

• Plastic Surgery
• Anesthesiology
• Pharmacology

Background:

• Rhytidectomy (facelift surgery) carries a notable risk of bleeding and hematoma formation.
• Tranexamic acid (TXA), an antifibrinolytic agent, has shown promise in mitigating perioperative bleeding in various surgical procedures.
• This review systematically evaluates TXA's efficacy and safety specifically within the context of rhytidectomy.

Approach:

• A comprehensive literature search identified studies investigating TXA in facelift surgery.
• Primary outcomes included intraoperative blood loss, hemostasis time, operation duration, and postoperative hematoma, edema, ecchymosis, and complications.
• Meta-analyses were conducted to assess the pooled prevalence and risk of hematoma, drain output, and complications, with risk of bias assessment.

Key Points:

• TXA administration, particularly subcutaneous injection, was analyzed in 170 patients within the review.
• A significant reduction in the risk of minor hematoma (OR = 0.18) and postoperative drainage (MD = -25.59 mL) was observed in TXA recipients.
• No significant increase in major hematoma or overall major/minor complications was found compared to controls.

Conclusions:

• TXA is effective in reducing minor hematomas and postoperative drainage following rhytidectomy.
• The antifibrinolytic agent also demonstrates benefits in decreasing edema, ecchymosis, and intraoperative blood loss.
• Further research is warranted to optimize TXA dosages and administration routes for facelift procedures.