Topische Applikation von Tranexamsäure im Rahmen der subkutanen Mastektomie bei Frau-zu-Mann Transidentität

Zusammenfassung

Abstrakt Einleitung Tranexamsäure (TXA) ist ein antifibrinolytisches Medikament, das zur Therapie von Blutungen als auch zur Blutungsprophylaxe verwendet werden kann. Die Anwendung in der plastischen und rekonstruktiven Chirurgie ist bisher äußerst begrenzt. Unseres Wissens fehlen bisher veröffentlichte Daten zur topischen Anwendung von TXA bei subkutaner Mastektomie transidenter Patienten.

Methoden Es erfolgte eine retrospektive Datenanalyse von Patienten, die eine subkutanen Mastektomie bei Frau-zu-Mann Transidentität erhielten. Insgesamt wurden 22 Patienten mit topisch applizierter TXA behandelt, während 29 Patienten als Vergleichsgruppe dienten. Primärer Endpunkt war die Menge der Wundsekretion in den ersten 48 h nach der Operation. Sekundäre Endpunkte waren die Dauer der Drainage und das Auftreten von Nachblutungen.

Ergebnisse Innerhalb der ersten 48 h zeigte sich in der Gruppe der TXA Patienten eine durchschnittliche Menge von 97±50 ml im Vergleich zu 180±111 ml in der Kontrollgruppe (p<0,01). Es zeigte sich eine signifikant geringere Fördermenge über den Gesamtzeitraum in der Gruppe der TXA Patienten 113±86 ml vs. 265±197 ml. Die Verweildauer der Drainagen lag in der TXA Gruppe bei 2,3±0,7 Tagen, während die Drainagen in der Kontrollgruppe im Durchschnitt 3,4±1,3 Tage in situ waren (p<0,01). In der Gruppe der mit TXA behandelten Patienten zeigte sich eine Tendenz zu einer geringeren Anzahl an Nachblutungen (9 vs. 17 %).

Diskussion Es zeigte sich eine signifikante Reduktion der Fördermenge über die Drainage innerhalb der ersten 48 h sowie über den Gesamtzeitraum nach topischer Applikation von TXA. Des Weiteren kam es zu einer Verkürzung des Zeitraums mit einliegender Drainage bei den mit TXA behandelten Patienten. Die vorliegende Studie konnte einen signifikanten Vorteil für die topische Anwendung von TXA bei subkutaner Mastektomie bei Frau-zu-Mann transidenten Patienten zeigen.

Abstract

Introduction Tranexamic acid (TXA) is an antifibrinolytic drug that can be used to treat and prevent bleeding. Its application in plastic and reconstructive surgery has been very limited to date. To our knowledge, there is a lack of published data on the topical application of TXA in transgender patients undergoing subcutaneous mastectomy.

Methods We performed a retrospective data analysis of female-to-male transgender patients who underwent subcutaneous mastectomy. A total of 22 patients were treated with topical TXA, while 29 patients served as controls. The primary endpoint was the amount of wound secretion in the first 48 hours after surgery. Secondary endpoints were the duration of drainage and the occurrence of postoperative bleeding.

Results Within the first 48 hours, the TXA group had an average drain volume of 97±50 ml compared with 180±111 ml in the control group (p<0.01). There was a significantly lower flow rate over the entire period in the group of TXA patients (113±86 ml vs. 265±197 ml). The time of drains in situ was 2.3±0.7 days in TXA patients, while the drains in the control group were in place for an average of 3.4±1.3 days (p<0.01). In the group of patients treated with TXA, there was a tendency towards a lower number of postoperative bleeding and haematoma (9vs. 17%).

Discussion There was a significant reduction in the amount of drain fluid within the first 48 hours and over the entire period after topical application of TXA. Also there was a reduction in the length of time patients had a drain in place in the TXA-treated patients. This study demonstrated a significant advantage for the topical application of TXA in subcutaneous mastectomy in female-to-male transgender patients.

Schlüsselwörter

Brustchirurgie - Transsexualismus<Interdisziplinäre plastische Chirurgie - Tranexamsäure

Key words

subcutaneous mastectomy - subcutane Mastektomie - tranexamic acid - transgender

Publikationsverlauf

Eingereicht: 24. März 2022

Angenommen: 05. Mai 2022

Artikel online veröffentlicht:
13. September 2022

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