Minimizing Blood Loss Using Tranexamic Acid in Patients Undergoing Liposuction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

[BACKGROUND] Liposuction has become the most sought-after aesthetic surgery across the globe, increasing the demand for more developments in patient safety protocols. Evidence of the efficacy of tranexamic acid (TXA) in reducing intraoperative blood loss with minimal complications have led to its widespread applications across various surgical operations. However, the role and effectiveness of TXA in liposuction is not fully understood. Therefore, the purpose of this systematic review and meta-analysis is to investigate the effectiveness of TXA in minimizing intraoperative blood loss in patients undergoing liposuction.

[METHODS] In adherence to the preferred reporting items for systematic reviews and meta-analysis guidelines, a comprehensive search was conducted in multiple databases including, PubMed, Cochrane CENTRAL, and Web of Science. Only randomized controlled trials (RCTs) were included without time frame limitations. Our primary outcomes were hemoglobin levels, hematocrit levels, lipoaspirate volume, and associated complications.

[RESULTS] This meta-analysis provides a comprehensive analysis of five RCTs published between 2021-2023, involving 334 patients. The pooled mean difference for postoperative hemoglobin levels was statistically significant in favor of local TXA administration (MD 0.54; P = 0.03; I= 0%). Analysis of postoperative hematocrit levels (g/dL) and lipoaspirate volume (L) mean differences were statistically insignificant (MD 0.76; P = 0.35; I= 0%) and (MD 0.19; P = 0.82; I= 85%) respectively. No complications related to the use of TXA occurred.

[CONCLUSION] Although a statistically significant difference was seen in postoperative hemoglobin levels, it is imperative that the results are interpreted with caution, given the preliminary nature of the observed effect. Further large well-designed RCTs are required to solidify current TXA protocols and to provide comprehensive guidelines for its application in liposuction.

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