Abstract

Postoperative complications of bleeding during breast surgery included hematoma, infection, and delayed recovery. Tranexamic acid (TXA) is a popular antifibrinolytic medication to minimize surgical hemorrhage, but the issue is whether it can be effective in breast surgery. This meta-analysis and systematic review assessed the effectiveness and safety of TXA to minimize the postoperative bleeding and complications in breast surgeries. The literature search included PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials, from their inception to June 2024. Randomized controlled trials were included that involved TXA and placebo in breast surgery only. The Cochrane ROB2 tool was used to assess the risk of bias, and RevMan 5.4 was used to analyze the data. Seven randomized controlled trials were selected, involving 647 patients who met the selection criteria. TXA also significantly reduced drainage volume and drainage time during the postoperative period compared with placebo. Moreover, the use of TXA was associated with a reduced risk of postoperative infection. There were no statistically significant differences in hematoma or seroma formation rates between the two groups. In general, the results indicated that TXA can help decrease blood loss and postoperative drainage and reduce the risk of infection during breast surgery, without increasing the risk of adverse events. Though TXA failed to show a definite advantage in the prevention of hematoma or seroma, it seems to be a safe and promising addition in breast surgical practice. More quality studies are justified to streamline the dosing protocols and their efficacy in various patient breast operations.

Key words: Bleeding reduction, breast surgeries, hemostasis, tranexamic acid, systematic review.