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

Abstract

Background: Abdominoplasty is a common body contouring procedure, with significant postoperative morbidity. Tranexamic acid (TXA), an antifibrinolytic agent, has demonstrated benefits in various surgical fields, presenting as a potential solution to address these challenges. Objectives: This study aims to evaluate the impact of combined TXA administration (intravenous and topical) on surgical outcomes 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: those receiving TXA therapy (1 g intravenous at anesthesia induction and 50 ml of 3% topical solution before wound closure) (n=61) and those who not receiving TXA (n=80). Postoperative outcomes, including suction drain output, duration of drain use, length of hospital stay, and complication rates (local and systemic), were compared. Results: Groups were comparable in baseline characteristics except for age. TXA use resulted in significantly lower total drain volumes (135 ± 110 mL vs. 186 ± 91 mL, p < 0.001), shorter drain use, and hospital stays, with 80% lower odds of prolonged drain use (OR = 0.20, 95% CI: 0.06, 0.60). No statistically significant differences were observed in postoperative complications, including seroma, hematoma, wound healing issues, or thromboembolic events. Conclusions: TXA use in abdominoplasty with Scarpa fascia preservation significantly reduces drainage volumes, hospital stay, and time until drain removal without increasing complication rates. These findings support TXA's potential role in improving recovery after abdominoplasty. Further prospective studies are needed to confirm these findings and establish standardized TXA protocols for abdominoplasty.