Optimising breast implant replacement surgery: Benefits of systemic tranexamic acid on post-operative blood loss and drain time.

Abstract

Minimising surgical bleeding is crucial for optimising outcomes in clinical practice. Tranexamic acid, an antifibrinolytic agent, has shown efficacy in various clinical fields and is receiving increased attention in plastic and aesthetic surgery. This study is the first to investigate the impact of systemic tranexamic acid on post-operative blood loss and bleeding complications in patients undergoing breast implant replacement with simultaneous capsulectomy for capsular contracture. After introducing systemic administration of 1 g tranexamic acid during surgery as routine prophylaxis, 40 patients (80 breasts) receiving this treatment were retrospectively compared to a historic cohort of 20 patients (40 breasts) who did not. The evaluated outcome parameters included 24-hour and total drain fluid production, drain time, and absolute and relative decreases in haemoglobin and haematocrit levels on the first operative day. Furthermore, bleeding complications such as the need for blood transfusion and haematoma evacuation were assessed. Tranexamic acid significantly reduced drainage volume within the first 24 h (72 ml versus 95 ml, 24.2%) and total drain fluid production (189 ml versus 351 ml, 46.2%). Additionally, a significantly shorter drainage time (3.9 d versus 7.1 d, 45.1%) and decreased post-operative decline in haemoglobin and haematocrit levels were observed. Regarding post-operative bleeding complications, 1 haematoma occurred in the tranexamic acid group versus 2 in the control group. Systemic administration of tranexamic acid effectively reduced post-operative blood loss and drain time in patients undergoing bilateral implant replacement surgery with capsulectomy.