The impact of topical tranexamic acid on drain duration and seroma volume in axillary lymph node dissection for breast cancer: A randomized controlled trial
A portion of this paper was presented as an abstract presentation at the San Antonio Breast Cancer Symposium; December 6–10, 2022, in San Antonio, Texas, and at the European Society of Medical Oncology—Breast Cancer 2022, May 3–5, 2022 in Berlin, Germany.
Abstract
Background
Seroma is the most common complication after breast surgery. Some studies showed that tranexamic acid (TA) can be used in breast surgery to reduce seroma formation and drain volume. We studied the effect of intra-operative and postoperative topical TA on the duration of drain and volume of seroma in patients undergoing axillary lymph node dissection (ALND) for breast cancer.
Patients and Methods
Breast cancer patients planned for ALND were enrolled in the study between July 2020 and July 2021. Patients were randomized into three groups where one group (n = 50) received a single intraoperative dose of diluted topical TA, the second group, in addition, received daily postoperative doses till day 5 through the suction drain, and the third group (n = 50) did not receive any dose. Chi-square tests and ANOVA were used to analyze the primary outcomes—the total volume of drain fluid and total drain duration, and secondary outcomes—daily drain output till postoperative-day-5, wound infection, and seroma rates.
Results
Patients receiving multiple doses of topical TA had a decreasing trend in total drain volume, although this was not statistically significant (1597 vs. 1763 vs. 1773 mL: p = 0.269). There was no significant change in the duration of the postoperative drain (21.6 vs. 19.2 vs. 19.55 days: p = 0.54). There was no statistically significant difference in complications between the groups.
Conclusion
There is no significant reduction in drain duration, total drain volume, or the rate of complications with the use of single or multiple doses of topical TA.
Key points
-
We evaluated the use of single and multiple doses of topical tranexamic acid for reducing drain volume and duration.
-
We noticed no significant effects.
-
There were no increased complications or drug side effects noticed.
CONFLICT OF INTEREST STATEMENT
The authors have no relevant financial or nonfinancial interests to disclose.
Open Research
DATA AVAILABILITY STATEMENT
The datasets generated during and analyzed during the current study are available with the primary author and a Google Drive link can be provided on demand.
