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The Role of Tranexamic Acid in Plastic Surgery: Review and Technical Considerations

Rohrich, Rod J. M.D.; Cho, Min-Jeong M.D.

Plastic and Reconstructive Surgery: February 2018 - Volume 141 - Issue 2 - p 507-515
doi: 10.1097/PRS.0000000000003926
Plastic Surgery Focus: Special Topics

Summary: Minimizing blood loss during surgery is critical, and many modalities have been used to decrease unwanted surgical bleeding. Among many methods, use of pharmacologic agents such as antifibrinolytic drugs has been shown to significantly reduce blood loss and the rates of postoperative blood transfusion in many articles. Tranexamic acid is an antifibrinolytic agent that has been widely used in other surgical specialties, especially in cardiac, orthopedic, and trauma surgery. Despite its known benefits, the use of tranexamic acid in plastic surgery is extremely limited, primarily because most plastic surgery procedures do not involve the extent of blood loss that can lead to anemia and the need for blood transfusion, as is common in major orthopedic and cardiac surgery procedures. Nevertheless, there are significant benefits to be gained from the use of antifibrinolytic drugs in the full range of plastic surgery. In this article, the authors introduce the benefits, dosages, and technical considerations of using tranexamic acid in plastic surgery procedures.

Dallas, Texas

From the Dallas Plastic Surgery Institute; and the Department of Plastic Surgery, University of Texas Southwestern Medical Center.

Received for publication April 15, 2017; accepted August 3, 2017.

Disclosure:Dr. Rohrich receives instrument royalties from Eriem Surgical, Inc., and book royalties from Thieme Medical Publishing. No funding was received for this article. Dr. Cho has no financial interest to declare in relation to the content of this article.

Rod J. Rohrich, M.D., Dallas Plastic Surgery Institute, 9101 North Central Expressway, Suite 600, Dallas, Texas 75231,

Copyright © 2018 by the American Society of Plastic Surgeons