Use of Plant-Based Absorbable Hemostatic Powder and Intravenous Tranexamic Acid in Breast Reduction Patients Reduces...

Area of Science:

• Plastic Surgery
• Surgical Oncology
• Wound Healing

Background:

• Reduction mammaplasty effectively treats symptomatic macromastia but carries risks of complications like hematoma and infection.
• Tranexamic acid (TXA) is known to reduce blood loss and hematoma in various surgeries.
• The effectiveness of topical agents like Arista in breast surgery is not well-established.

Purpose of the Study:

• To evaluate the combined effect of intravenous tranexamic acid (TXA) and topical Arista on reducing postoperative complications after reduction mammaplasty.
• To compare the efficacy of TXA alone, Arista plus TXA, and no treatment in managing surgical site complications.

Main Methods:

• A retrospective cohort study included 464 patients undergoing bilateral reduction mammaplasty.
• Patients were categorized into three groups: TXA + Arista (n=120), TXA alone (n=133), and control (n=211).
• Primary outcome was hematoma incidence; secondary outcomes included seroma, infection, and delayed wound healing.

Main Results:

• The combination of TXA and Arista showed the lowest total hematoma rate (2.5%) compared to TXA alone (3.8%) and control (10.0%).
• Infection rates were significantly lower in the TXA + Arista group (0.8%) versus TXA alone (6.8%) and control (2.8%).
• Delayed wound healing was also significantly reduced with combined treatment (1.7%) compared to TXA alone (16.5%) and control (11.4%).

Conclusions:

• Intravenous TXA is effective in reducing hematoma after reduction mammaplasty.
• Adding topical Arista provides a modest additional benefit in reducing hematoma and infection.
• Arista may be a useful alternative for patients unable to receive TXA, warranting further investigation.