Tranexamic acid reduces postoperative blood loss in lipedema patients undergoing large-volume power-assisted liposuction

Lipdema is a chronic adipose tissue disorder withpainful fat accumulation in the extremities, oftentreated by large volume (> 5 L) power-assisted liposuction (PAL). However, perioperative blood loss remains a key concern. Antifibrinolytic Tranexamic acid (TXA) has shown promise in reducing blood loss in various surgical settings, but its effect in lipedema-related PAL remains underexplored.e

This study evaluates the efficacy of intraoperative TXA administration in minimizing postoperative blood loss measured in the difference of hemoglobin in lipedema patients undergoing large volume PAL in 24 patients (control group = 12, intervention group = 12). The intervention group received 1 g oftranexamicacid at the start of the surgery, the control group did not. Patient characteristics, complication rates and postoperative hemoglobin levels were recorded and analyzed.

Patient demographics were homogenous and did not differ significantly in age, BMI, preoperative hemoglobin, intraoperative fluid balance or aspirated volume (p > 0,05) throughout both groups. Patients who received TXA demonstrated a significantly reduced perioperative loss of hemoglobin (p = 0,03) compared to controls, even when taking perioperative intravenous fluid substitution into account. No differences in postoperative pain, postoperative complicationsor hospital stay duration was observed (p > 0,05).

Intraoperative use of TXA during PAL in lipedema patients reduces postoperative blood loss without observed thromboembolic complications. The findings support the integration of TXA as a standard adjunct in surgical protocols for lipedema management and align with broader literature highlighting the hemostatic benefits of TXA in aesthetic surgery. Level of Evidence: Level III, risk / prognostic study.