<< Back to the abstract archive
Prospective Study Assessing the Effect of Local Infiltration of Tranexamic Acid on Facelift Bleeding
Andrew L Kochuba MD, Nicholas Sinclair MD, Demetrius Coombs MD, and James E Zins MD FACS
Cleveland Clinic
2020-01-30
Presenter: Andrew Kochuba
Affidavit:
I agree
Director Name: Dr. James Zins
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
BACKGROUND: Rebound bleeding during facelift surgery may lead to serious complications. Subcutaneous infiltration of transexamic acid (TXA), anti-fibrinolytic, combined with dilute lidocaine and epinephrine was recently shown to decrease rebound bleeding. No study has prospectively examined the effect of TXA on bleeding complications in facelift surgery.
OBJECTIVES: To demonstrate that TXA combined with local anesthesia safely reduces the untoward effects of rebound bleeding, decreases drainage, and is efficacious.
METHODS: Prospective, single surgeon, case control study from July 2019 to present day. 27 patients underwent facelift surgery alone or in combination with facial rejuvenation procedures. All patients were injected subcutaneously with 1-2mg/cc TXA + 0.5% Lidocaine/1:200,000 Epinephrine following our protocol. Patient demographics, TXA dose, time to hemostasis, drain output, minor and major complications were examined.
RESULTS: 25 patients were female, 2 were male (mean 65.7 years, range 49-80 years). Average OR drying time was 6.7min and 6.4min for the right and left side, respectively. Average POD 0 drain outputs were 10.5cc and 12.3cc on the right and left sides. Average POD 1 drain outputs were 14.1cc on both sides. All drains were removed on POD 1 for females and POD 2 for males. Complications included 4 minor (skin slough) and 1 major (marginal mandibular neuropraxia).
CONCLUSION: Rebound bleeding associated with epinephrine is a problematic occurrence in facelift surgery. TXA safely and effectively decreased bleeding, OR time, and drain output compared to traditional local. Future goal is to determine if epinephrine can be completely removed and replaced with TXA for facelift surgery.
