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Meta-Analysis
. 2023 May 1;151(5):949-957.
doi: 10.1097/PRS.0000000000010071. Epub 2022 Dec 19.

Tranexamic Acid Use in Breast Surgery: A Systematic Review and Meta-Analysis

Rémy Liechti  1 , Bryan J M van de Wall  2   3 , Urs Hug  1 , Elmar Fritsche  1 , Alberto Franchi  1
Affiliations
Meta-Analysis

Tranexamic Acid Use in Breast Surgery: A Systematic Review and Meta-Analysis

Rémy Liechti et al. Plast Reconstr Surg. .

Abstract

Background: The perioperative use of tranexamic acid (TXA) has become popular among plastic surgeons for a variety of surgical procedures. The aim of this study was to perform a systematic review and meta-analysis on the results reported in the literature regarding the effect of perioperative systemic TXA administration in breast surgery.

Methods: The PubMed, MEDLINE, Embase, CENTRAL, and CINAHL databases were searched for both randomized clinical trials and observational studies. Effect estimates were pooled across studies using random effects models and presented as weighted odds ratio with corresponding 95% confidence interval.

Results: A total of five studies encompassing 1139 patients undergoing mastectomy with or without immediate implant or free flap-based breast reconstruction or breast-conserving surgery with or without axillary lymph node dissection were included. Perioperative intravenous administration of TXA significantly reduced the risk for hematoma (7.3% versus 12.9%; OR, 0.43; 95% CI, 0.23 to 0.81) and seroma formation (11.5% versus 19.9%; OR, 0.57; 95% CI, 0.35 to 0.92) in comparison to the control group. In the studies measuring the postoperative drainage amount, the mean difference was 132 mL (95% CI, 220 to 44 mL). No thromboembolic event occurred in either group. The weighted surgical-site infection rate was higher in the control group (3.1% versus 1.5%). However, these data were too sparse to perform comparative meta-analysis.

Conclusion: Evidence of this study suggests that perioperative administration of TXA significantly reduces the risk for postoperative hematoma and seroma formation in breast surgery, whereas the risk for thromboembolic events and postoperative infection is not increased.

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References

    1. Seth AK, Hirsch EM, Kim JYS, et al. Hematoma after mastectomy with immediate reconstruction: an analysis of risk factors in 883 patients. Ann Plast Surg. 2013;71:20–23.
    1. Collins JB, Verheyden CN. Incidence of breast hematoma after placement of breast prostheses. Plast Reconstr Surg. 2012;129:413e–420e.
    1. Manrique OJ, Banuelos J, Abu-Ghname A, et al. Surgical outcomes of prepectoral versus subpectoral implant-based breast reconstruction in young women. Plast Reconstr Surg Glob Open. 2019;7:e2119.
    1. Pan X-F, Huan J-L, Qin X-J. Potential risk factors for the development of seroma following mastectomy with axillary dissection. Mol Clin Oncol. 2015;3:222–226.
    1. Hershenhouse KS, Bick K, Shauly O, et al. Systematic review and meta-analysis of immediate versus delayed autologous breast reconstruction in the setting of post-mastectomy adjuvant radiation therapy. J Plast Reconstr Aesthet Surg. 2021;74:931–944.