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The Aesthetic Surgery Education and Research Foundation

Tranexamic Acid Pharmacokinetics in Tumescent Solution: What Dose is Safe? Print

Researcher: Joseph Hunstad, MD

Grant Award: ASERF Interim Grant

Amount Awarded: $18,095

Project Name: Tranexamic Acid Pharmacokinetics in Tumescent Solution: What Dose is Safe?

Project Summary: The overall aim of this study is to evaluate the efficacy of tranexamic acid (TXA) administered subcutaneously within tumescent fluid on blood loss, ecchymosis and seroma rates using a prospective, blinded, randomized control trial. Additionally, we will evaluate the pharmacokinetics of TXA using mass microscopy. The results of this study will provide preliminary definitive information on the efficacy of TXA reducing blood loss for liposuction procedures for plastic surgeons, and the safety profile of TXA when added to tumescent solution. These data, and knowledge obtained from our study, will contribute to advances in aesthetic plastic surgery, especially reduction in blood loss. The goal is to guide plastic surgeons in applying evidence-based medicine to their practices to prevent complications and improve outcomes.

The primary objective is to determine the efficacy of TXA in preventing postoperative ecchymosis, seroma, and intraoperative blood loss as well as the pharmacokinetics of TXA. We will investigate the amount of blood loss in liposuction infranatant fluid after infiltration with tumescent solution containing TXA compared to tumescent fluid without TXA. Lastly, we will objectively and subjectively assess postoperative bruising using artificial intelligence.

We hypothesize that the use of tumescent infiltration containing TXA into the subcutaneous tissue will reduce blood loss, bruising and seroma rates. We also hypothesize that a dose of 500 mg of TXA (1 cc/mL) added to 1L of tumescent solution will be a safe dose of TXA without added risk of toxicity.

Upon completion of the study, it is our expectation that we will be able to demonstrate the safety of TXA added to tumescent solution by its pharmacokinetic profile. We expect to show a significant decrease in intraoperative blood loss, postoperative ecchymosis, and seroma rates in the TXA study group compared to the standard tumescent liposuction control group.

Differences in Surgical Practices for Transgender Mastectomy Print
Researchers: Ali R. Abtahi, DO, MSc

Grant Award: ASERF Interim Grant

Amount Awarded: $2,300

Project Name: Differences in Surgical Practices for Transgender Mastectomy

Project Summary: The purpose of this study is to evaluate the differences in surgical practices among surgeons performing transgender mastectomies throughout the United States. Currently, no evidence-based “best practices” or standards of care have been developed for chest masculinization, particularly regarding appropriate preoperative evaluation, surgical approaches, protocols for handling breast specimens, and postoperative screening and/or referral regimens.

Our goal is to report on the varying practices among surgeons throughout the United States and how such factors such as practice type (private vs. academic vs. hospital employment), region or payment model (insurance vs. self-pay vs. crowd sourcing vs. Medicaid) may affect pre/post-operative management and/or operative decision-making.

We hope to better understand what practice patterns are most common, the rationale behind these practices, and determine whether these procedures would benefit from formal guidelines established by an American Society for Aesthetic Plastic Surgery (The Aesthetic Society) or American Society of Plastic Surgeons (ASPS) sanctioned expert panel.
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