The Critical Blood-sparing Effect Of Tranexamic Acid In Liposuction: A Systematic Review And Meta-analysis
Myrna Eliann Reinhardt, BA, BM1, Sudeep Mutyala, BS2, Mykal Gerald, BS2, Huaqing Zhao, PhD3, Vitalina Nova, MSLIS4, Sthefano Araya Cambronero, MD2, Sameer Patel, MD2, Pablo Baltodano, MD5.
1Albany Medical College, Albany, NY, USA, 2Fox Chase Cancer Center, Philadelphia, PA, USA, 3Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA, 4Temple University, Charles Library, Philadelphia, PA, USA, 5Miami Beauty Specialists, Miami, FL, USA.
Purpose: Tranexamic acid (TXA) has been used to improve bleeding outcomes in many surgical procedures. However, its blood-sparing effect in liposuction is not well established.
Methods: A systematic literature search was performed using: PubMed, EMBASE, CINAHL, Cochrane Central, ClinicalTrials.gov, and WorldWideScience.org databases from their inception to October 8, 2021 according to PRISMA guidelines. The authors focused on 3 main topics: 1) TXA; 2) liposuction; 3) complications. We included articles evaluating potential blood-sparing effects of TXA in liposuction. Studies were excluded according to the following criteria: systematic review article or protocol paper, animal studies, conference abstract, survey study, and non-English publication.
Results: A total of 685 articles were identified with one retrospective and 4 prospective (3 randomized) studies meeting our inclusion criteria.1-5 TXA was utilized in various forms: IV either on induction or after the procedure, mixed into the tumescent solution, or infiltrated into the liposuction sites after lipoaspiration. A significantly smaller reduction in hematocrit was noted in the TXA group compared to the Non-TXA group (p<0.001) despite a significantly greater amount of lipoaspirate removed in the TXA group (p<0.001). Patients in non-TXA cohorts experienced adverse effects (such as seroma and need for transfusion) that were not seen in TXA cohorts.
Conclusion: TXA use in liposuction patients seems to be associated with a beneficial blood-sparing effect, which may enhance safety in this population. 
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