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The Efficacy of Topical Tranexamic Acid in Breast Surgery Evaluating the Drain Output and Complications Reduction: A Systematic Review and Meta-Analysis Sudarman, Jesica Putri; Sayudo, Iqbal Farhan; Putri, Marcelvina Mutiara; Ali, Gary; Handini, Nurliati Sari
Jurnal Plastik Rekonstruksi Vol. 11 No. 1 (2024): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/

Abstract

Introduction : The topical administration of Tranexamic Acid (TXA) has gained significant attention for its potential advantages in various plastic surgery procedures. This study aims to conduct a systematic review and meta-analysis focusing on the use of topical TXA in breast surgery, analysing its impact on postoperative drain output and complications. Method : PubMed, Embase and the Cochrane Library databases were systematically searched to identify relevant studies. The data synthesis utilized random-effects models and the findings were presented as a mean difference and weighted odds ratio along with the corresponding 95% confidence interval. Results : Seven studies including four RCTs and three observational studies, comprising 1,553 breasts undergoing surgery were included. The average age of participants was 46 years; mean body mass index (BMI) was 26.1 kg/mm2. Of the breasts studied, 764 (49%) received topical TXA and 789 (51%) received normal saline as placebo. Overall, topical TXA was associated with a lower drain output in the first 24 hours postoperative (MD -25.87; p=0.00001) and a lower cumulative drain output (MD -59.72; p<0.00001). The rate of hematoma is significantly lower in the topical TXA group compared to the control group (OR 0.19; p=0.0009). There were no significant differences in rates of seroma, infection, thromboembolic events and time to drain removal between groups.   Conclusion: Evidence of this study suggests that administration of topical TXA significantly reduces the drain output production and hematoma in breast surgery. The use of topical TXA not significantly affecting rates of seroma, infection and postoperative duration with drain.
How to Harvest Deep Inferior Epigastric Perforator Free Flap Ramadan, Mohamad Rachadian; Keusuma, Khanza Isdiharana; Ali, Gary; Maharani, Anisa Ayu; Sarena, Ayu Putri Balqis
Jurnal Plastik Rekonstruksi Vol. 12 No. 2 (2025): Jurnal Plastik Rekonstruksi
Publisher : The Lingkar Studi Bedah Plastik Foundation and is affiliated with the Department of Plastic Surgery, Faculty of Medicine, Universitas Indonesia.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jprjournal.v12i2.47

Abstract

Summary : The Deep Inferior Epigastric Perforator (DIEP) free flap is a microsurgical breast reconstruction technique that uses skin and subcutaneous fat from the lower abdomen while preserving the rectus abdominis muscle. This approach provides a natural breast mound with minimal donor-site morbidity compared to TRAM flaps, reducing risks of muscle weakness and abdominal wall hernia. Advantages include improved postoperative recovery, better abdominal contour, and long-lasting aesthetic results, as the reconstructed breast maintains its volume over time. However, it is technically demanding, requires longer operative time, and carries risks of flap loss or vascular complications if microsurgery fails. The procedure involves dissecting perforator vessels from the deep inferior epigastric system, transferring the tissue to the chest, and connecting vessels under a microscope. Expected outcomes include a soft, natural breast shape with improved patient satisfaction, though surgical expertise and careful patient selection are essential to minimize complications and ensure optimal results.
The Efficacy of Topical Tranexamic Acid in Breast Surgery Evaluating The Drain Output and Complications Reduction: A Systematic Review and Meta-Analysis Sudarman, Jesica Putri; Sayudo, Iqbal F.; Putri, Marcelvina Mutiara; Ali, Gary; Handini, Nurliati Sari
Jurnal Plastik Rekonstruksi Vol. 11 No. 1 (2024): (2024) Jurnal Plastik Rekonstruksi
Publisher : The Lingkar Studi Bedah Plastik Foundation and is affiliated with the Department of Plastic Surgery, Faculty of Medicine, Universitas Indonesia.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jprjournal.v11i1.370

Abstract

Introduction : The topical administration of Tranexamic Acid (TXA) has gained significant attention for its potential advantages in various plastic surgery procedures. This study aims to conduct a systematic review and meta-analysis focusing on the use of topical TXA in breast surgery, analysing its impact on postoperative drain output and complications.Method : PubMed, Embase and the Cochrane Library databases were systematically searched to identify relevant studies. The data synthesis utilized random-effects models and the findings were presented as a mean difference and weighted odds ratio along with the corresponding 95% confidence interval.Results : Seven studies including four RCTs and three observational studies, comprising 1,553 breasts undergoing surgery were included. The average age of participants was 46 years; mean body mass index (BMI) was 26.1 kg/mm2. Of the breasts studied, 764 (49%) received topical TXA and 789 (51%) received normal saline as placebo. Overall, topical TXA was associated with a lower drain output in the first 24 hours postoperative (MD -25.87; p=0.00001) and a lower cumulative drain output (MD -59.72; p<0.00001). The rate of hematoma is significantly lower in the topical TXA group compared to the control group (OR 0.19; p=0.0009). There were no significant differences in rates of seroma, infection, thromboembolic events and time to drain removal between groups.  Conclusion: Evidence of this study suggests that administration of topical TXA significantly reduces the drain output production and hematoma in breast surgery. The use of topical TXA not significantly affecting rates of seroma, infection and postoperative duration with drain.