Tranexamic Acid in Body Contouring Surgery: A Systematic Review and Meta-Analysis

Abstract

Breast and body contouring procedures are plastic surgery's most popular and effective interventions. Although these procedures are generally safe, they are not without risks and complications. Antifibrinolytic drugs such as tranexamic acid (TXA) have been used as an adjunct to improve outcomes. The authors of this meta-analysis explore the impact of TXA on complications in breast and body contouring procedures. They searched PubMed (US National Library of Medicine, Bethesda, MD) for studies that used TXA in standard breast reconstruction and body contouring procedures. They then performed a meta-analysis on the following complications: hematoma, seroma, infection, and wound-healing complications. A Mantel-Haenszel method random-effects model was used to calculate the odds ratio (OR) within and a 95% CI for dichotomous outcomes. Subgroups were created for studies that utilized systemic (IV), topical or concurrent IV, and topical TXA administration. A total of 13 studies were selected and included in the analysis. There was a significant lower risk of hematoma (OR = 0.37; 95% CI = 0.18-077; P = .008) in the TXA cohort. There were no significant differences observed in terms of wound-healing issues or seroma formation. The subgroup analysis of this study demonstrated significantly decreased risks of infection (OR = 0.41; 95% CI = 0.22-077; P = .005) in the topical TXA cohort. In breast and body contouring procedures, the risk of hematoma and wound-healing complications can potentially be reduced by IV TXA administration. The infection risk can be potentially reduced by topical TXA administration. Level of Evidence: 3 (Therapeutic).

Figure 1.

PRISMA diagram of the study selection process.

Figure 2.

Forest plot with the odds ratio for hematoma formation in breast and abdominal body contouring procedures.

Figure 3.

Forest plot with the odds ratio for hematoma formation.

Figure 4.

Forest plot with odds ratio for seroma formation.

Figure 5.

Forest plot with odds ratio for the rate of surgical-site infection.

Figure 6.

Forest plot with odds ratio for wound-healing complication rates.