The Impact of Combined Intravenous and Topical Tranexamic Acid in Abdominoplasty with Scarpa Fascia Preservation: A Pilot Study.

BACKGROUND: Abdominoplasty is a common body contouring procedure. Optimization of surgical outcomes should be pursued. Tranexamic acid (TXA), an antifibrinolytic agent, has demonstrated benefits in various surgical fields, presenting as a potential solution to address these challenges. This study evaluates the impact of combined TXA administration in patients undergoing abdominoplasty with Scarpa fascia preservation. METHODS: A retrospective analysis of 141 patients undergoing full abdominoplasty was performed. Patients were divided into two groups: TXA Group (n = 61, receiving 1 g intravenous TXA at anesthesia induction and 50 mL of a 3% TXA solution applied topically before wound closure) and no-TXA Group (n = 80, no TXA administration). Postoperative outcomes were compared, including suction drain output, duration of drain use, length of hospital stay, and complication rates (local and systemic). RESULTS: Groups were homogeneous in baseline characteristics except for age. TXA use resulted in a 27% reduction in total drain output (p < 0.001), shorter drain use (p < 0.001), and hospital stay (p < 0.001), with 81% lower odds of prolonged drain use (OR 0.19, 95% CI [0.06, 0.57]) In the TXA group, drains could be removed on the first day in 42% of the cases as opposed to 2% in the no-TXA group (p < 0.001). No statistically significant differences were observed in postoperative complications, including seroma, hematoma, wound healing issues, or thromboembolic events. CONCLUSIONS: Combined TXA use in abdominoplasty with Scarpa fascia preservation significantly reduces drain output, hospital stay, and time until drain removal without increasing complication rates. These findings support TXA's potential role in improving recovery after abdominoplasty. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .