Ethan Fung, Keisha E Montalmant, Jacquelyn M Roth, Maxwell Godek, Jian H Li, Bernice Z Yu, Peter W Henderson
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Primary outcomes assessed were hematoma and seroma; secondary outcomes assessed were surgical site infection (SSI), nipple-areola complex (NAC) necrosis, drain output, drain duration, and thromboembolic events. Data were pooled, and a meta-analysis was performed. Odds ratios (OR) and mean differences were reported via the Mantel-Haenszel and Inverse-Variance methods, respectively.</p><p><strong>Results: </strong>Seven studies with a total of 1396 patients were included, with 53.1% of patients (n = 741) receiving TXA. Of those receiving TXA, 100% of patients received TXA intraoperatively, and 62.6% of patients (n = 464) received both topical and intravenous administration. TXA administration significantly reduced postoperative hematoma formation (OR 0.35; 95% CI [0.20-0.63]; P < 0.001), with 2.3% of patients (n = 17) developing hematomas in the TXA group, compared to 7.2% of patients (n = 47) in those who did not receive TXA. No statistically significant differences were found in seroma rates, SSI, NAC necrosis, or drain duration. No thromboembolic events were reported in either group.</p><p><strong>Conclusion: </strong>TXA administration during reduction mammaplasty reduced the incidence of postoperative hematoma formation without increasing complications.</p><p><strong>Level of evidence iii: </strong>This journal requires that authors assign a level of evidence to each article. 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引用次数: 0
摘要
背景:在整形外科医生中,氨甲环酸(TXA)在缩小乳房成形术中的应用越来越多。然而,其疗效和对并发症的影响尚不清楚。本研究旨在综合评价TXA对缩乳术术后预后的影响。方法:根据PRISMA指南进行系统评价。我们查询了5个数据库,以确定报告TXA在乳房手术中的应用的研究。采用双筛选方法选择缩小乳房成形术研究进行全文筛选。评估的主要结局是血肿和血清肿;评估的次要结局是手术部位感染(SSI)、乳头乳晕复合体(NAC)坏死、引流量、引流时间和血栓栓塞事件。对数据进行汇总,并进行meta分析。优势比(OR)和平均差异分别通过Mantel-Haenszel和反方差方法报告。结果:7项研究共纳入1396例患者,53.1%的患者(n = 741)接受TXA治疗。在接受TXA治疗的患者中,100%的患者术中接受了TXA治疗,62.6%的患者(n = 464)同时接受了局部和静脉给药。TXA可显著减少术后血肿形成(OR 0.35;95% ci [0.20-0.63];结论:缩乳术中应用TXA可降低术后血肿的发生率,且未增加并发症。证据等级iii:本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述,请参阅目录或在线作者说明www.springer.com/00266。
Utility of Tranexamic Acid in Reduction Mammaplasty: A Systematic Review and Meta-Analysis.
Background: The use of tranexamic acid (TXA) in reduction mammaplasty is increasing among plastic surgeons. Its efficacy and impact on complications, however, are not yet well understood. This study aims to comprehensively evaluate the impact of TXA on postoperative outcomes in reduction mammoplasty.
Methods: A systematic review was conducted according to PRISMA guidelines. Five databases were queried to identify studies reporting TXA application in breast surgery. A dual-screener approach was employed to select reduction mammaplasty studies for full-text screening. Primary outcomes assessed were hematoma and seroma; secondary outcomes assessed were surgical site infection (SSI), nipple-areola complex (NAC) necrosis, drain output, drain duration, and thromboembolic events. Data were pooled, and a meta-analysis was performed. Odds ratios (OR) and mean differences were reported via the Mantel-Haenszel and Inverse-Variance methods, respectively.
Results: Seven studies with a total of 1396 patients were included, with 53.1% of patients (n = 741) receiving TXA. Of those receiving TXA, 100% of patients received TXA intraoperatively, and 62.6% of patients (n = 464) received both topical and intravenous administration. TXA administration significantly reduced postoperative hematoma formation (OR 0.35; 95% CI [0.20-0.63]; P < 0.001), with 2.3% of patients (n = 17) developing hematomas in the TXA group, compared to 7.2% of patients (n = 47) in those who did not receive TXA. No statistically significant differences were found in seroma rates, SSI, NAC necrosis, or drain duration. No thromboembolic events were reported in either group.
Conclusion: TXA administration during reduction mammaplasty reduced the incidence of postoperative hematoma formation without increasing complications.
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 .
期刊介绍:
Aesthetic Plastic Surgery is a publication of the International Society of Aesthetic Plastic Surgery and the official journal of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE), Vereinigung der Deutschen Aesthetisch Plastischen Chirurgen (VDAPC), the Romanian Aesthetic Surgery Society (RASS), Asociación Española de Cirugía Estética Plástica (AECEP), La Sociedad Argentina de Cirugía Plástica, Estética y Reparadora (SACPER), the Rhinoplasty Society of Europe (RSE), the Iranian Society of Plastic and Aesthetic Surgeons (ISPAS), the Singapore Association of Plastic Surgeons (SAPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Egyptian Society of Plastic and Reconstructive Surgeons (ESPRS), and the Sociedad Chilena de Cirugía Plástica, Reconstructiva y Estética (SCCP).
Aesthetic Plastic Surgery provides a forum for original articles advancing the art of aesthetic plastic surgery. Many describe surgical craftsmanship; others deal with complications in surgical procedures and methods by which to treat or avoid them. Coverage includes "second thoughts" on established techniques, which might be abandoned, modified, or improved. Also included are case histories; improvements in surgical instruments, pharmaceuticals, and operating room equipment; and discussions of problems such as the role of psychosocial factors in the doctor-patient and the patient-public interrelationships.
Aesthetic Plastic Surgery is covered in Current Contents/Clinical Medicine, SciSearch, Research Alert, Index Medicus-Medline, and Excerpta Medica/Embase.