Effectiveness of Tranexamic Acid in Postbariatric Surgery Abdominoplasty: Improving Hemostasis and Recovery Outcomes

Background: Postbariatric abdominoplasty carries an increased risk of perioperative bleeding due to extensive dissection and tissue fragility. Tranexamic acid (TXA) effectively reduces blood loss in several surgical fields, but evidence in postbariatric body-contouring surgery remains limited. Methods: A single-center, retrospective pilot study of 200 postbariatric abdominoplasty patients was conducted. One hundred patients received perioperative TXA (intravenous and local), and 100 historical controls did not. Outcomes measured included hemoglobin drop, 24-hour drain output, complications, and hospital stay. Results: TXA use significantly reduced hemoglobin drop (1.6 ± 0.5 versus 3.1 ± 0.7 g/dL; P < 0.001), drain output (82 versus 154 mL; P < 0.01), and hospital stay (3.0 ± 0.4 versus 4.3 ± 0.6 d; P < 0.001). No thromboembolic events occurred. Conclusions: TXA is associated with reduced blood loss and shorter hospitalization in postbariatric abdominoplasty, without increased thromboembolic risk. TXA should be considered as part of perioperative management for this population.