Topical Tranexamic Acid and Chest Masculinization Surgeries—Impact on Postoperative Hematoma Incidence
Summary: Introduction: Postoperative hematoma requiring intervention occurs more frequently in chest masculinization surgeries than in other types of breast surgeries, with incidences ranging from 0.7% to 13.2% per patient. Although there is increasing evidence that topically applied tranexamic aci...
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Elsevier
2025-03-01
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352587825000075 |
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| author | Krisztina Sipos Katriina Joensuu Susanna Kauhanen Kaisu Ojala |
| author_facet | Krisztina Sipos Katriina Joensuu Susanna Kauhanen Kaisu Ojala |
| author_sort | Krisztina Sipos |
| collection | DOAJ |
| description | Summary: Introduction: Postoperative hematoma requiring intervention occurs more frequently in chest masculinization surgeries than in other types of breast surgeries, with incidences ranging from 0.7% to 13.2% per patient. Although there is increasing evidence that topically applied tranexamic acid (TXA) effectively reduces postoperative bleeding in breast surgeries, its impact on masculinization surgeries is understudied. Aims: Examining the significance of topical TXA in reducing postoperative hematoma in chest masculinization surgeries. Methods: This retrospective cohort comprises female-to-male transgender and non-binary patients who underwent chest masculinization at Helsinki or Tampere University hospitals between 2018 and 2024. Topical TXA (20 mg/ml, 25 ml per breast) was incorporated into routine use in October 2022, replacing the previous practices; Helsinki mainly operated without TXA, whereas Tampere routinely used intravenous (i.v.) TXA. Results: A total of 198 patients undergoing chest masculinization surgery were included. Among them, 9 (4.5%) major hematomas occurred. The need for reoperation due to postoperative hematoma was lower in the topical TXA (3.2%, 2 out of 63 patients) and i.v. TXA (3.4%, 2 out of 58 patients) groups compared to the non-TXA group (6.5%, 5 out of 77 patients). Subpectoral incisions (71.2%, 141 patients) resulted in a 5.0% hematoma rate, whereas periareolar incisions (28.8%, 57 cases) had a 3.5% hematoma rate. Conclusions: Our study suggests that topical and i.v. TXA effectively reduce postoperative bleeding in chest masculinization surgeries, with similar outcomes between the 2 methods. Albeit our results lack statistical significance and they support the potential benefit of prophylactic TXA use in hematoma reduction. |
| format | Article |
| id | doaj-art-d3082d631ea64406942bdefedb1d9859 |
| institution | Kabale University |
| issn | 2352-5878 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JPRAS Open |
| spelling | doaj-art-d3082d631ea64406942bdefedb1d98592025-02-05T04:32:13ZengElsevierJPRAS Open2352-58782025-03-0143458469Topical Tranexamic Acid and Chest Masculinization Surgeries—Impact on Postoperative Hematoma IncidenceKrisztina Sipos0Katriina Joensuu1Susanna Kauhanen2Kaisu Ojala3Department of Musculoskeletal and Plastic Surgery, University of Helsinki, and Helsinki University Hospital, Finland; Corresponding author: Krisztina Sipos, MD, Helsinki University Hospital, Department of Musculoskeletal and Plastic Surgery, Stenbäckinkatu 11, 00290, Helsinki, Finland.Department of Plastic Surgery, Tampere University Hospital, FinlandDepartment of Musculoskeletal and Plastic Surgery, University of Helsinki, and Helsinki University Hospital, FinlandDepartment of Musculoskeletal and Plastic Surgery, University of Helsinki, and Helsinki University Hospital, FinlandSummary: Introduction: Postoperative hematoma requiring intervention occurs more frequently in chest masculinization surgeries than in other types of breast surgeries, with incidences ranging from 0.7% to 13.2% per patient. Although there is increasing evidence that topically applied tranexamic acid (TXA) effectively reduces postoperative bleeding in breast surgeries, its impact on masculinization surgeries is understudied. Aims: Examining the significance of topical TXA in reducing postoperative hematoma in chest masculinization surgeries. Methods: This retrospective cohort comprises female-to-male transgender and non-binary patients who underwent chest masculinization at Helsinki or Tampere University hospitals between 2018 and 2024. Topical TXA (20 mg/ml, 25 ml per breast) was incorporated into routine use in October 2022, replacing the previous practices; Helsinki mainly operated without TXA, whereas Tampere routinely used intravenous (i.v.) TXA. Results: A total of 198 patients undergoing chest masculinization surgery were included. Among them, 9 (4.5%) major hematomas occurred. The need for reoperation due to postoperative hematoma was lower in the topical TXA (3.2%, 2 out of 63 patients) and i.v. TXA (3.4%, 2 out of 58 patients) groups compared to the non-TXA group (6.5%, 5 out of 77 patients). Subpectoral incisions (71.2%, 141 patients) resulted in a 5.0% hematoma rate, whereas periareolar incisions (28.8%, 57 cases) had a 3.5% hematoma rate. Conclusions: Our study suggests that topical and i.v. TXA effectively reduce postoperative bleeding in chest masculinization surgeries, with similar outcomes between the 2 methods. Albeit our results lack statistical significance and they support the potential benefit of prophylactic TXA use in hematoma reduction.http://www.sciencedirect.com/science/article/pii/S2352587825000075TransgenderMasculinizationBreast surgeryTranexamic acidHematomaPostoperative complications |
| spellingShingle | Krisztina Sipos Katriina Joensuu Susanna Kauhanen Kaisu Ojala Topical Tranexamic Acid and Chest Masculinization Surgeries—Impact on Postoperative Hematoma Incidence JPRAS Open Transgender Masculinization Breast surgery Tranexamic acid Hematoma Postoperative complications |
| title | Topical Tranexamic Acid and Chest Masculinization Surgeries—Impact on Postoperative Hematoma Incidence |
| title_full | Topical Tranexamic Acid and Chest Masculinization Surgeries—Impact on Postoperative Hematoma Incidence |
| title_fullStr | Topical Tranexamic Acid and Chest Masculinization Surgeries—Impact on Postoperative Hematoma Incidence |
| title_full_unstemmed | Topical Tranexamic Acid and Chest Masculinization Surgeries—Impact on Postoperative Hematoma Incidence |
| title_short | Topical Tranexamic Acid and Chest Masculinization Surgeries—Impact on Postoperative Hematoma Incidence |
| title_sort | topical tranexamic acid and chest masculinization surgeries impact on postoperative hematoma incidence |
| topic | Transgender Masculinization Breast surgery Tranexamic acid Hematoma Postoperative complications |
| url | http://www.sciencedirect.com/science/article/pii/S2352587825000075 |
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