Efficacy and Safety of Tranexamic Acid in Abdominoplasty: A Systematic Review and Meta-Analysis

Vollständiger Abstract

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Background: Abdominoplasty is associated with postoperative bleeding, drainage, and seroma. Methods: We searched four databases from inception through 16 May 2026 for randomized and non-randomized comparative studies of systemic or topical tranexamic acid (TXA). Results: Seven studies (one randomized controlled trial and six observational studies) reported 763 participants across source cohorts; treatment-arm assignment was available for 753. Random-effects meta-analysis associated TXA with lower total drainage volume (MD: −233.32 mL, 95% CI: −351.43 to −115.21), shorter drainage time (MD: −1.36 days, 95% CI: −1.75 to −0.97), shorter hospital stay (MD: −1.48 days, 95% CI: −2.16 to −0.80), smaller absolute hemoglobin drop (MD: −0.87 g/dL, 95% CI: −1.72 to −0.02), and lower seroma odds (OR: 0.51, 95% CI: 0.27 to 0.96). No significant differences were observed for 24 h drainage, relative hemoglobin drop, hematoma, surgical-site infection, wound-healing disorder, or transfusion. Rare adverse events were insufficiently reported. The absolute-hemoglobin and seroma associations were not robust to leave-one-out analysis, and major Doi-plot asymmetry affected several outcomes. Conclusions: TXA may improve selected early outcomes, but the small, mainly observational evidence base supports cautious individualized use rather than a universal regimen.