Use of tranexamic acid in plastic surgery: Literature review

Authors

DOI:

https://doi.org/10.33448/rsd-v15i4.50794

Keywords:

Tranexamic acid, Plastic Surgery, Hyperpigmentation, Pharmacokinetics, Hemostasis.

Abstract

There are multiple perioperative measures to prevent complications, ranging from appropriate patient selection to the use of medications to reduce intraoperative blood loss. The current trend is prevention rather than treatment, and tranexamic acid (TXA) has been tested in multiple surgical procedures. The objective is to demonstrate the usefulness of TXA through intravenous, topical, and oral routes; to increase its use in Aesthetic and Reconstructive Surgery procedures to reduce intraoperative blood loss, as well as to reduce ecchymosis and inflammation, in order to ensure greater patient safety. Material and Methods: A bibliographic review was conducted using PubMed, Elsevier, Google Scholar, Research, and SciELO databases; articles in Portuguese, English, and Spanish were included using “AND” for different terms and “OR” for synonyms, covering the period between 2015 and 2024. Results: Through knowledge of the pharmacokinetics of TXA, we verified that, in addition to its usefulness in preventing hemorrhage, it also plays a role in reducing ecchymosis and inflammation. Conclusions: This study contributes to a better understanding of the use of TXA in preventing bleeding in aesthetic and reconstructive surgeries, as well as its intraoperative and postoperative complications.

References

Ajai, K. S., Kumar, P., Subair, M., & Sharma, R. K. (2022). Effect of single dose intravenous tranexamic acid on blood loss in tangential excision of burn wounds—a double blind randomised controlled trial. Burns, 48(6), 1311-1318.

Arantes, GC, Pereira, RMR, de Melo, DB, Alonso, N., & Duarte, MDCM (2017). Eficácia do ácido tranexâmico na redução do sangramento intraoperatório em palatoplastias: um ensaio clínico randomizado. Journal of Cranio-Maxillofacial Surgery , 45 (5), 642-648.

Ausen, K., Hagen, A. I., Østbyhaug, H. S., Olafsson, S., Kvalsund, B. J., Spigset, O., & Pleym, H. (2020). Topical moistening of mastectomy wounds with diluted tranexamic acid to reduce bleeding: randomized clinical trial. BJS open, 4(2), 216-224.

Bayter-Marín, J. E., Hoyos, A., Cárdenas-Camarena, L., Peña-Pinzón, W., Bayter-Torres, A. F., Díaz-Díaz, C. A., McCormick-Méndez, M., Plata-Rueda, E. L., & Niño-Carreño, C. S. (2023). Effectiveness of tranexamic acid in the postoperative period in body contour surgery: Randomized clinical trial. Plastic and Reconstructive Surgery – Global Open, 11(11), e5403. https://doi.org/10.1097/GOX.0000000000005403

Beikaei, M., Ghazipour, A., Derakhshande, V., Saki, N., & Nikakhlagh, S. (2015). Avaliando o efeito do ácido tranexâmico intravenoso no sangramento intraoperatório durante cirurgia de rinoplastia eletiva. Biomed Pharmacol J , 8 (Edição Especial de Outubro), 723-759.

Butz, D R, & Geldner, P D (2016). O uso do ácido tranexâmico em pacientes submetidos à ritidectomia. Plastic and Reconstructive Surgery–Global Open , 4 (5), e716.

Cansancao, A. L., Condé-Green, A., David, J. A., Cansancao, B., & Vidigal, R. A. (2018). Use of tranexamic acid to reduce blood loss in liposuction. Plastic and Reconstructive Surgery, 141(5), 1132–1135. https://doi.org/10.1097/PRS.0000000000004282

Cohen, J C, Glasgold, R A, Alloju, L M, & Glasgold, M J (2021). Efeitos do ácido tranexâmico intravenoso durante a ritidectomia: um estudo piloto randomizado, controlado e duplo-cego. Aesthetic surgery journal , 41 (2), 155-160.

Crossetti, M. G. O. (2012). Revisão integrativa de pesquisa na enfermagem o rigor cientifico que lhe é exigido. Rev Gaúcha Enferm. 33(2):8-9.

Dominguez, A., Alsina, E., Landin, L., Garcia-Miguel, JF, Casado, C., & Gilsanz, F. (2016). Necessidades de transfusão em pacientes queimados submetidos à excisão primária da ferida: efeito do ácido tranexâmico. Minerva anestesiológica , 83 (4), 353-360.

Eikebrokk, T A, Vassmyr, B S, Ausen, K., Gravastrand, C., Spigset, O., & Pukstad, B. (2019). Citotoxicidade e efeito na reepitelização da ferida após administração tópica de ácido tranexâmico. BJS open , 3 (6), 840-851.

Fuentes-Alzate, J. J., Fuentes-Torrado, E. A., & Alzate-Granados, J. P. (2021). Aplicación de ácido tranexámico para la reducción del sangrado perioperatorio en la cirugía estética corporal. Revista 16 de abril, 60(282), e1405-e1405.

Galindo, O L G, Hoyos, F A N, & Yacub, Y L Á. (2022). Situação atual da aplicação de biopolímeros em cirurgia estética de glúteos: Uma revisão sistemática aplicando o guia PRISMA. Revista Colombiana de Cirugía Plástica e Reconstrutiva , 28 (1), 28-36.

Ghavimi, M. A., Taheri Talesh, K., Ghoreishizadeh, A., Chavoshzadeh, M. A., & Zarandi, A. (2017). Efficacy of tranexamic acid on side effects of rhinoplasty: A randomized double-blind study. Journal of Cranio-Maxillofacial Surgery, 45(6), 897–902. https://doi.org/10.1016/j.jcms.2017.03.001

Guo, J., Gao, X., Ma, Y., Lv, H., Hu, W., Zhang, S., ... & Shi, J. (2019). Different dose regimes and administration methods of tranexamic acid in cardiac surgery: a meta-analysis of randomized trials. BMC anesthesiology, 19(1), 129.

Knight, H., Banks, J., Muchmore, J., Ives, C., & Green, M. (2019). Examinando o uso do ácido tranexâmico intraoperatório na cirurgia oncoplástica da mama. Breast Journal , 25 (5).

Montroy, J., Hutton, B., Moodley, P., Fergusson, NA, Cheng, W., Tinmouth, A., ... & Breau, RH (2018). A eficácia e segurança do ácido tranexâmico tópico: uma revisão sistemática e meta-análise. Transfusion Medicine Reviews , 32 (3), 165-178.

Pereira, A. S. et al. (2018). Metodologia da pesquisa científica. [free ebook]. Santa Maria: Editora da UFSM.

Risemberg, R. I. C. et al. (2026). A importância da metodologia científica no desenvolvimento de artigos científicos. E-Acadêmica, 7(1), e0171675. https://eacademica.org/eacademica/article/view/675.

Sakallioglu, Ö., Polat, C., Soylu, E., Düzer, S., Orhan, I., & Akyigit, A. (2015). A eficácia do ácido tranexâmico e do corticosteróide no edema e equimose na septorrinoplastia. Annals of plastic surgery , 74 (4), 392-396.

Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of Business Research. 104, 333-9. https://doi.org/10.1016/j.jbusres.2019.07.039.

Tejada, V. F. D. S., Zhang, L., & Zogbi, L. (2024). Uso transoperatório tópico do ácido tranexâmico em cirurgia plástica reconstrutora em tumores faciais: Ensaio clínico randomizado. Revista do Colégio Brasileiro de Cirurgiões, 51, e20243761.

Trejos, S. O., Beltrán, E. S., Pinzón, J. G., Marín, J. B., & Suarez, R. G. (2018). Disminución del riesgo en cirugía plástica. Recomendaciones. Parte I: generalidades y cirugía estética facial. Revista Colombiana de Cirugía Plástica y Reconstructiva, 24(1).

Weissler, J. M, Kuruoglu, D., Salinas, C., Tran, N. V, Nguyen, M. D. T, Martinez-Jorge, J., ... & Sharaf, B. (janeiro de 2022). Definindo o papel do ácido tranexâmico administrado topicamente na cirurgia de paniculectomia. In Aesthetic Surgery Journal Open Forum (Vol. 4, p. ojac033). EUA: Oxford University Press.

Published

2026-04-23

Issue

Section

Review Article

How to Cite

Use of tranexamic acid in plastic surgery: Literature review. Research, Society and Development, [S. l.], v. 15, n. 4, p. e8015450794, 2026. DOI: 10.33448/rsd-v15i4.50794. Disponível em: https://www.rsdjournal.org/rsd/article/view/50794. Acesso em: 2 may. 2026.