Safety and Efficacy of Tranexamic Acid in Liposuction: A Review of Current Literature.

backgroundTranexamic acid (TXA) is a synthetic lysine analogue that competitively binds to the activation site of plasminogen, inhibiting its conversion to active plasmin, leading to decreased degradation of fibrin clots by plasmin. The use of TXA has been shown to be an effective and safe adjunct for reducing perioperative bleeding in many surgical subspecialties but has only recently started to gain popularity within plastic surgery. This study evaluates the current data regarding the route of administration, dosage, safety, and efficacy of TXA specifically in liposuction procedures.

methodsThe study systematically reviewed the current literature evaluating effects of TXA on liposuction blood loss. The authors collected and evaluated available data for route of administration, dosage, safety, and efficacy of TXA use during liposuction procedures.

resultsThere are 7 available studies that evaluate the efficacy and safety of TXA use in liposuction procedures. Studies utilized intravenous, oral, or local TXA. No two studies used the same combination of dose and route of administration. All studies support that blood loss is reduced with the use of TXA. IV and local TXA alone effectively reduce bleeding; however, there is conflicting data on whether IV or local TXA alone produces superior reduction in blood loss. The available data suggest that the two modalities produce a greater reduction in blood loss when combined. Local TXA has been shown to be comparable to or more effective than systemic TXA in other surgery specialties, but the data for liposuction are inconclusive. None of the studies report complications associated with the use of TXA.

conclusionsThe current data support that TXA is safe and effective in reducing blood loss associated with liposuction. There is no consensus for the best route of administration or dose of TXA with liposuction, and this study highlights the need for additional research from which administration guidelines can be formed. 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 .