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Li XB, Kang CY, Zhang XF, Ren ZQ, Wu SF. Assessment of Blood Volume in Liposuction Fluids Using Colorimetry. Aesthetic Plast Surg 2024; 48:1457-1464. [PMID: 37658189 DOI: 10.1007/s00266-023-03547-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 07/23/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVE The possibility of using a color contrast method to evaluate blood loss during liposuction was assessed. A color chart of blood-lipid content associated with different blood volumes was developed. METHODS Three color cards with different concentrations of blood were developed based on clinical parameters. The color cards were used to evaluate the volume of blood present in liposuction solutions obtained from 60 clinical liposuction patients. The red blood cell count also was evaluated for each patient. The data obtained using each evaluation method were compared and statistically analyzed to determine the most accurate calculation formula. RESULTS The red blood cell counts were compared to the color card results. The paired t test results for the calculated values for the 3:1, 2:1, and 1:1 color cards and the red blood cell count values were comparable (44.3 ± 22.1 ml vs. 53.6 ± 25.0 ml, t = 10.5; 45.4 ± 19.0 ml vs. 55.2 ± 20.7 ml, t = 18.1; 41.9 ± 25.6 ml vs. 52.8 ± 28.3 ml, t = 14.0). The P values were < 0.05, and the difference between the two groups was statistically significant. The average standard error of the mean was 0.90, 0.54, and 0.77, respectively. Sixty samples were evaluated in a scatter diagram using the two detection methods. Trend analysis revealed that the two results demonstrated a linear increase (y = 5.6 + 1.1x), R2 = 0.989, indicating that the two inspection methods were highly correlated with only small errors. CONCLUSION The colorimetric card protocol developed in this study could quickly, accurately, and conveniently calculate blood volumes in liposuction fluids, which has considerable clinical significance. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .
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Affiliation(s)
- Xiang-Bin Li
- Department of Plastic Surgery, Bravou Plastic Surgery Hospital, Chengdu, 610000, Sichuan, China
| | - Chun-Yu Kang
- Department of Plastic Surgery, Bravou Plastic Surgery Hospital, Chengdu, 610000, Sichuan, China.
| | - Xue-Feng Zhang
- Department of Plastic Surgery, Bravou Plastic Surgery Hospital, Chengdu, 610000, Sichuan, China
| | - Zhao-Qiang Ren
- Department of Plastic Surgery, Bravou Plastic Surgery Hospital, Chengdu, 610000, Sichuan, China
| | - Su-Fan Wu
- Department of Plastic Surgery, Zhejiang Provincial People's Hospital, Hangzhou, 310000, Zhejiang, China
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Seretis K. Tranexamic Acid Irrigation in Liposuction: A Double-Blind, Half-Body, Randomized, and Placebo-Controlled Trial. Aesthetic Plast Surg 2024; 48:68-69. [PMID: 37821552 DOI: 10.1007/s00266-023-03684-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 09/14/2023] [Indexed: 10/13/2023]
Affiliation(s)
- Konstantinos Seretis
- Department of Plastic Surgery, Medical School, University of Ioannina, Leoforos St. Niarchou, 45500, Ioannina, Greece.
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Wolf Y, Skorochod R, Kwartin S, Shapira L. Tranexamic Acid Irrigation in Liposuction: A Double-Blind, Half-Body, Randomized, Placebo-Controlled Trial. Aesthetic Plast Surg 2023; 47:2525-2532. [PMID: 37488309 DOI: 10.1007/s00266-023-03499-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 06/30/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Hematomas are common complications following plastic and esthetic surgeries. Large and complex hematomas might result in prolonged hospitalization, further interventions, additional expenses, and poor esthetic outcome. Tranexamic acid (TXA), an antifibrinolytic agent, has long been used to reduce blood loss. Its use in the field of plastic surgery has gained popularity recently. Several studies have presented the ability of TXA to reduce blood loss, hematomas, and ecchymoses after liposuctions. However, the proper dose and the route of administration remained controversial. OBJECTIVE The objective of the study was to quantify the effect of a low dose of TXA in an irrigation method in reducing hematomas and ecchymoses following liposuction. METHODS A prospective randomized controlled trial was conducted. Following liposuction, 400 mg of TXA were administered in an irrigation protocol to one side of the body in each patient, while the other side was administered with saline. The patients were photographed on 1, 2, 4, and 11 post-operative days. Ecchymosis and hematoma were measured and rated. RESULTS No statistical difference was observed between the intervention and control groups in terms of RBC in liposuction area (p = 0.11), RBC in lipoaspirate (p = 0.79), bruising size on days 1, 2, 4, and 11 (p = 0.68, 0.21, 0.42, and 0.75), and average ecchymosis score on the same days (p = 0.34, 0.72, 0.09, and 1) CONCLUSIONS: The use of a low-dose TXA irrigation solution did not demonstrate a statistically significant difference in post-operative hematoma formations rates and subsequent ecchymosis size and scale. LEVEL OF EVIDENCE II 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 .
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Affiliation(s)
- Yoram Wolf
- Plastic Surgery Unit, Hillel Yaffe Medical Center, P.O.B 169, 38100, Hadera, Israel.
| | - Ron Skorochod
- Plastic Surgery Unit, Hillel Yaffe Medical Center, P.O.B 169, 38100, Hadera, Israel
| | - Shmuel Kwartin
- Plastic Surgery Unit, Hillel Yaffe Medical Center, P.O.B 169, 38100, Hadera, Israel
| | - Liran Shapira
- Plastic Surgery Unit, Hillel Yaffe Medical Center, P.O.B 169, 38100, Hadera, Israel
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Bayter-Marín JE, Hoyos A, Cárdenas-Camarena L, Peña-Pinzón W, Bayter-Torres AF, Díaz-Díaz CA, McCormick-Méndez M, Plata-Rueda EL, Niño-Carreño CS. Effectiveness of Tranexamic Acid in the Postoperative Period in Body Contour Surgery: Randomized Clinical Trial. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5403. [PMID: 38025645 PMCID: PMC10653580 DOI: 10.1097/gox.0000000000005403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/26/2023] [Indexed: 12/01/2023]
Abstract
Background Tranexamic acid (TXA) is used to reduce bleeding in body contouring procedures; however, there are no studies that show the effectiveness of TXA when it is also used in the immediate postoperative period. Methods A controlled, randomized, parallel, and open-label clinical trial was carried out in adult patients undergoing liposculpture and/or abdominoplasty. A control group administering presurgical TXA and a study group with presurgical and postsurgical TXA were formed. The decrease in hemoglobin and the incidence of blood transfusions between both groups were compared as well as the possible adverse effects of TXA. Results Four hundred twenty-seven subjects were included, 208 (48.7%) in the control group and 219 (51.3%) in the study group. The median age was 34 years (interquartile range 28-42). Median postoperative hemoglobin levels at 24 hours were similar in both groups (study 11.3 g/dL versus control 11.1 g/dL, P = 0.07); however, at 72 hours, postoperative hemoglobin was higher in the study group versus control (10.8 versus 10.0 g/dL, P ≤ 0.001). The incidence of transfusions at 72 hours was 1.8% in the study group and 8.6% in the control group, for a risk ratio of 0.21 (95% confidence interval 0.07-0.61). There were no adverse or thromboembolic events. Conclusion TXA proved to be more effective in reducing intra- and postsurgical bleeding and the need for transfusions, when used preoperatively and continued for 48 hours after surgery, than when used only preoperatively, without reporting adverse or thromboembolic effects.
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Affiliation(s)
- Jorge Enrique Bayter-Marín
- From the Universidad Industrial de Santander
- Department of Reanimation Critical and Intensive Care, Universidad La Sabana, Bucaramanga, Colombia
- Clínica “EL Pinar” Bucaramanga, Colombia
| | | | | | - William Peña-Pinzón
- Department of Anesthesiology and Perioperative Medicine, Fundación Universitaria Sanitas, Bucaramanga, Colombia
| | | | | | | | - Erika Liliana Plata-Rueda
- Department of Anesthesiology and Perioperative Medicine, Universidad Industrial de Santander, Fundación Universitaria Sanitas, Bucaramanga, Colombia
| | - Claudia Stella Niño-Carreño
- Department of Anesthesiology and Perioperative Medicine, Fundación Universitaria Sanitas, Bucaramanga, Colombia
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Hua Z, Wei P. Letter on Efficacy and Safety of Tranexamic Acid for the Control of Surgical Bleeding in Patients Under Liposuction. Aesthetic Plast Surg 2023:10.1007/s00266-022-02916-5. [PMID: 37798504 DOI: 10.1007/s00266-022-02916-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 10/07/2023]
Affiliation(s)
- Zuguang Hua
- Ningbo No1 Hospital, No. 59, Liuting Street, Haishu District, Ningbo, 315000, Zhejiang, People's Republic of China.
| | - Peng Wei
- Ningbo No1 Hospital, No. 59, Liuting Street, Haishu District, Ningbo, 315000, Zhejiang, People's Republic of China
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Wang S, Yang J, Lin L. Local Application of Tranexamic Acid in Plastic Surgery Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Aesthetic Plast Surg 2023:10.1007/s00266-023-03281-7. [PMID: 36810834 DOI: 10.1007/s00266-023-03281-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 01/30/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND According to recent evidence, the use of local tranexamic acid (TXA) during plastic surgery may lessen blood loss. OBJECTIVES To comprehensively assess the use of local TXA during plastic surgery through a systematic review and meta-analysis of randomized controlled trials addressing these issues. METHODS Four electronic databases, including PubMed, Web of Science, Embase and the Cochrane Library, were searched until December 12, 2022. Following meta-analyses, the mean difference (MD) or standardized mean difference (SMD) for blood loss volume (BLV), ΔHct, ΔHb and operation time were calculated when appropriate. RESULTS Eleven randomized controlled trials were included in the qualitative synthesis, while 8 studies were included in the meta-analysis. Compared with the control group, the local TXA group showed a reduction in blood loss volume of -1.05 (p < 0.00001; 95% CI, -1.72 to -0.38). However, local TXA had a limited effect on reducing ΔHct, ΔHb and operation time. A meta-analysis was not performed because of heterogeneity in other outcomes; however, except for 1 study in which no significant difference was observed on POD 1, all studies showed significantly lower rates of postoperative ecchymosis after surgery, 2 studies showed statistically significant reductions in transfusion risk or volume, and 3 studies reported significantly better surgical field quality in operations with local TXA. In the 2 included studies, the researchers concluded that local treatment does not play a role in relieving postoperative pain. CONCLUSIONS Local TXA is associated with less blood loss, less ecchymosis and better surgical field in plastic surgery patients. LEVEL OF EVIDENCE I 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 .
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Affiliation(s)
- Senmao Wang
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. Bada Road, Shijingshan District, Beijing, 100144, China
| | - Jingwen Yang
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. Bada Road, Shijingshan District, Beijing, 100144, China
| | - Lin Lin
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. Bada Road, Shijingshan District, Beijing, 100144, China.
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Xiong Y, Guo X, Huang X, Kang X, Zhou J, Chen C, Pan Z, Wang L, Goldbrunner R, Stavrinou L, Stavrinou P, Lin S, Chen Y, Hu W, Zheng F. Efficacy and safety of tranexamic acid in intracranial haemorrhage: A meta-analysis. PLoS One 2023; 18:e0282726. [PMID: 37000863 PMCID: PMC10065302 DOI: 10.1371/journal.pone.0282726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/21/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Although some studies have shown that tranexamic acid is beneficial to patients with intracranial haemorrhage, the efficacy and safety of tranexamic acid for intracranial haemorrhage remain controversial. METHOD The PubMed, EMBASE, and Cochrane Library databases were systematically searched. The review followed PRISMA guidelines. Data were analyzed using the random-effects model. RESULTS Twenty-five randomized controlled trials were included. Tranexamic acid significantly inhibited hematoma growth in intracranial hemorrhage (ICH) and traumatic brain injury (TBI) patients. (ICH: mean difference -1.76, 95%CI -2.78 to -0.79, I2 = 0%, P < .001; TBI: MD -4.82, 95%CI -8.06 to -1.58, I2 = 0%, P = .004). For subarachnoid hemorrhage (SAH) patients, it significantly decreased the risk of hydrocephalus (OR 1.23, 95%CI 1.01 to 1.50, I2 = 0%, P = .04) and rebleeding (OR, 0.52, 95%CI 0.35 to 0.79, I2 = 56% P = .002). There was no significance in modified Rankin Scale, Glasgow Outcome Scale 3-5, mortality, deep vein thrombosis, pulmonary embolism, or ischemic stroke/transient ischemic. CONCLUSION Tranexamic acid can significantly reduce the risk of intracranial haemorrhage growth in patients with ICH and TBI. Tranexamic acid can reduce the incidence of complications (hydrocephalus, rebleeding) in patients with SAH, which can indirectly improve the quality of life of patients with intracranial haemorrhage.
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Affiliation(s)
- Yu Xiong
- Department of Neurosurgery, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, Fujian Province, China
| | - Xiumei Guo
- Department of Neurosurgery, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, Fujian Province, China
- Department of Neurology, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, Fujian Province, China
| | - Xinyue Huang
- Department of Neurosurgery, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, Fujian Province, China
| | - Xiaodong Kang
- Department of Neurosurgery, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, Fujian Province, China
| | - Jianfeng Zhou
- Department of Neurosurgery, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, Fujian Province, China
| | - Chunhui Chen
- Department of Neurosurgery, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, Fujian Province, China
| | - Zhigang Pan
- Department of Neurosurgery, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, Fujian Province, China
| | - Linxing Wang
- Department of Neurology, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, Fujian Province, China
| | - Roland Goldbrunner
- Department of Neurosurgery, Center for Neurosurgery, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Lampis Stavrinou
- 2nd Department of Neurosurgery, "Attikon" University Hospital, National and Kapodistrian University, Athens Medical School, Athens, Greece
| | - Pantelis Stavrinou
- Department of Neurosurgery, Center for Neurosurgery, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
- Neurosurgery, Metropolitan Hospital, Athens, Greece
| | - Shu Lin
- Centre of Neurological and Metabolic Research, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
- Diabetes and Metabolism Division, Garvan Institute of Medical Research, Sydney, NSW, Australia
- * E-mail: (FZ); (WH); (YC); (SL)
| | - Yuping Chen
- Department of Neurosurgery, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, Fujian Province, China
- * E-mail: (FZ); (WH); (YC); (SL)
| | - Weipeng Hu
- Department of Neurosurgery, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, Fujian Province, China
- * E-mail: (FZ); (WH); (YC); (SL)
| | - Feng Zheng
- Department of Neurosurgery, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, Fujian Province, China
- * E-mail: (FZ); (WH); (YC); (SL)
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8
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Stoehr JR, Fine NA. Considerations for Differentiating the Effects of Intravenous and Topical Tranexamic Acid in Liposuction in Future Research Protocols. Aesthet Surg J Open Forum 2021; 3:ojab033. [PMID: 34859207 PMCID: PMC8631072 DOI: 10.1093/asjof/ojab033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Jenna R Stoehr
- Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Neil A Fine
- Corresponding Author: Dr Neil A. Fine, Department of Plastic Surgery, Northwestern University Feinberg School of Medicine, Arkes Family Pavilion, Suite 1575, 676 N Saint Clair, Chicago, IL 60611, USA. E-mail:
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