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Impact Of Intravenous Tranexamic Acid Administration On Reduction Mammoplasty Outcomes
Stephanie Francalancia, MS, Mary Lou, BS, Kathryn Leeke, BA, Margaret Wang, BS, Damon McIntire, MD, Nikhil Sobti, MD, Daniel Kwan, MD, Lauren Roussel, MD, Amy Maselli, MD, Rachel Sullivan, MD, Paul Liu, MD, Karl Breuing, MD.
Brown University Warren Alpert Medical School, Providence, RI, USA.
Purpose: Tranexamic acid’s (TXA) exponentially growing use in plastic surgery necessitates an accurate analysis of its efficacy in reduction mammoplasty. We provide a large cohort evaluation of intravenous TXA’s role in minimizing postoperative complications.
Methods: A single-institution retrospective analysis was conducted on reduction mammoplasties from February 2023-August 2024. Patient demographics, intraoperative factors, and postoperative complications were collected and summarized with descriptive statistics. Analysis was separated into those who were and weren’t given intravenous TXA, with differences assessed using Wilcoxon rank sum test for continuous variables and Fisher’s exact test for categorical variables. Association of intraoperative TXA use with postoperative complications was analyzed with multivariable logistic regression.
Results: Of 386 patients (768 breasts), 208 patients (415 breasts) had intravenous TXA administered intraoperatively. Neither group had significant differences in Caprini score, prior history of DVT, or anemia. Multivariable regression controlled for differences in breast mass removed and drain usage; TXA use was significantly associated with decreased rates of dehiscence (OR=0.48, 95% CI 0.26-0.89, p=0.019) and readmission (OR=0.45, 95% CI 0.24-0.84, p=0.015) (
Figure 1). There was no significant association between TXA use and rates of DVT/PE, seroma, hematoma, infection, nipple insensitivity, hypertrophic scarring, or fat necrosis.
Conclusions: Intravenous TXA use in reduction mammoplasty confers lower rates of wound dehiscence and hospital readmission, building upon the expanding support for its increased use.
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