Effect of Intravenous and Topical Tranexamic Acid on Drain Output in Breast Reduction Surgery
The Effect of Tranexamic Acid on Drainage Volume and Time to Drain Removal in Reduction Mammaplasty Patients
Massachusetts General Hospital
160 participants
Nov 18, 2025
INTERVENTIONAL
Conditions
Summary
This study aims to evaluate whether tranexamic acid (TXA), a medication that helps reduce bleeding, can decrease fluid drainage after breast reduction surgery. Participants will be randomly assigned to receive either intravenous TXA or no TXA during surgery. Additionally, one breast will receive TXA through the surgical drain, while the other will receive saline. This approach allows to compare the effects of TXA on fluid buildup and healing. The goal is to improve recovery and reduce complications after breast reduction surgery.
Eligibility
Inclusion Criteria4
- Adults aged 18 years or older
- Elective bilateral breast reduction
- Patient understands and is willing to participate in the study
- Patient willing to and capable of providing informed consent
Exclusion Criteria12
- Age less than 18 years old
- Prior radiation to the breast
- Secondary/Revision breast reduction
- Known coagulopathy or bleeding disorders
- Intraoperative coagulopathy
- History of seizures
- Active smokers
- Allergy or contraindication to TXA
- Pregnant or breastfeeding patients
- Patient is unable or unwilling to complete the anticipated study follow-up
- Inability to understand the aims and objectives of the study
- Inability to or unwilling to provide informed consent
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Interventions
Patients randomized to the IV TXA group will receive intravenous Tranexamic acid during the procedure. The dose will be 1g IV infused over approx. 10 minutes prior to skin closure (dosing of approx. 15 mg/kg, capped at 1 g, which is within safe limits).
Before wound closure, one 15mm round Jackson-Pratt (JP) drain is placed in each breast pocket, exiting through a lateral chest wall stab incision. The randomized topical TXA intervention is then applied through the drain into the breast after skin closure. The drains will then be temporarily clamped for 20 minutes to allow the TXA to dwell in the tissue and exert local effect. After this the clamp is released, the excess fluid sucked off and the drain connected to a drainage bottle.
Before wound closure, one 15mm round Jackson-Pratt (JP) drain is placed in each breast pocket, exiting through a lateral chest wall stab incision. The randomized saline intervention is then applied through the drain into the breast after skin closure. The drains will then be temporarily clamped for 20 minutes to allow the saline to dwell in the tissue and exert local effect. After this the clamp is released, the excess fluid sucked off and the drain connected to a drainage bottle.
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT07131592