The Laryngoscope
October 1, 2026 · via Europe PMC
Impact of Tranexamic Acid on Head and Neck Free Flap Outcomes: A Retrospective Cohort Analysis.
Adams G, Fried I, Longfellow GA, +6 more, Sullivan CB.
AI summary — for doctors, generated from the abstract only
Tranexamic acid in head and neck free flap surgery showed no difference in flap outcomes or thrombotic events.
What was studied
A single-institution retrospective cohort of 215 adults undergoing free flap reconstruction (2023-2024), 15.3% of whom received TXA.
Key findings
- Transfusion rates did not differ after adjustment (p=0.21)
- POD1 hemoglobin drop was smaller with TXA (-1.84 vs -2.77 g/dL), but the difference resolved by POD7
- No difference in recipient site, donor site or medical complications
Clinical relevance
TXA appears safe in free tissue transfer, but benefit is unclear.
Who should care
Limitations
Small number of TXA patients, retrospective, with potential confounding by indication.
TXA seems safe in head and neck free flaps; await prospective trials for evidence of benefit.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objective
Tranexamic acid (TXA) is an antifibrinolytic agent studied for its role in reducing perioperative bleeding. While it has shown promise in operations requiring free tissue transfer in plastic surgery, its application in head and neck free flap reconstruction is less documented. This study evaluates the impact of TXA on head and neck free flap surgery outcomes.
Methods
This was a single-institution retrospective cohort study of adult patients who underwent head and neck reconstruction with autologous free tissue transfer between May 2023 and October 2024. Multivariable logistic regression and linear regression were used to evaluate differences between groups. Odds ratios and 95% confidence intervals were used to describe associations.
Results
A total of 215 patients were included (15.3% receiving TXA). Patients who received TXA had a higher rate of intraoperative transfusions (p = 0.049). This difference was not observed after adjustment for other factors (p = 0.21). Patients who received TXA had a more stable hemoglobin at Postoperative Day (POD) 1 (-1.84 ± 1.62 vs. -2.77 ± 1.36 g/dL, p = 0.045), however, this difference resolved by POD 7 with no difference in postoperative transfusion rates (p = 0.22). There was no difference in postoperative recipient site, donor site, or medical complications between groups.
Conclusions
Head and neck free flap patients that received TXA had no significant difference in flap outcomes or major thrombotic events. Our results suggest that TXA is a safe option among patients undergoing free tissue transfer for head and neck reconstruction. Further prospective research with larger cohort sizes is needed to elucidate potential benefits.
Level of evidence: 3
DOI
10.1002/lary.70933
PMID
42820342
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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