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PURPOSE: The role of topical TXA in gender affirming mastectomy (GAM) remains less understood. Thus, this study aims to investigate the impact of topical TXA on the reduction of postoperative bleeding complications for patients undergoing GAM. METHODS: A single-center retrospective cohort study was conducted to examine the postoperative bleeding outcomes of patients who underwent GAM between February 2022 and September 2023. Rates of hematoma and other postoperative complications were analyzed. RESULTS: A total of 102 patients were included in this study, comprising two groups: 68 consecutive control patients (136 breasts) and 34 consecutive patients (68 breasts) who received topical moistening of 10 ml of 50mg/ml TXA on each breast. The two groups were comparable in age, body mass index, and smoking status. Both groups exhibited similar psychiatric history, medical comorbidities, and intraoperative characteristics. Postoperative hematoma occurred in two patients who received topical TXA and in three patients who did not receive it (p = 0.72). The average duration of post operative drains were 10.6 days and 10.1 days for the TXA and control group, respectively. Moreover, the incidence of other postoperative complications such as seroma and wound infection did not differ significantly between groups. CONCLUSION: This study did not reveal any statistically significant differences in the rates of postoperative bleeding complications between the two groups. These preliminary findings enrich the growing literature suggesting that, for individuals undergoing GAM, the intravenous administration of TXA may be more beneficial than its topical application.
Falade et al. (Wed,) studied this question.