The Use of Tranexamic Acid in Orthognathic Surgery for Swelling Control: An Observational Study

(Pages: 47-52)

Gianmarco Saponaro1, Giulio Gasparini1, Piero Doneddu1, Mattia Todaro1, Mariacristina Azzuni2, Carlo Polidori2, Giuseppe D’Amato1, Sandro Pelo1 and Alessandro Moro1

1Maxillo-Facial Surgery Unit – Fondazione Policlinico Universitario “A. Gemelli” – Università Cattolica del Sacro Cuore – Rome, Italy; 2Pharmacology and Pharmacotherapy 2 Dpt – Università degli Studi di Camerino, Italy




Abstract: Orthognathic surgery refers to the surgical correction of maxillomandibular abnormalities. This abnormality may consist of a congenital disability, a growth defect, or be the result of traumatic injuries to the jaw area.
Surgical correction of these deformities mostly takes advantage of basal and segmental osteotomies, which are used to place the jaws into the desired position. These surgical procedures involve extended subperiosteal dissection, bone osteotomies, and detachment of masticatory muscles, provoking intense swelling of the middle and lower face as a direct consequence of the excessive accumulation of serous fluid and blood in the tissue, interstitial spaces, and virtual spaces surgically created by anatomic structure detachment. This swelling the main cause of postoperative patient discomfort.
Tranexamic acid (TXA) is a synthetic compound derived from the amino acid lysine, which inhibits the fibrinolysis system. The aim of the present study was to compare the post operative stage in patients treated with the standard protocol plus TXA and those who were treated with the standard postoperative protocol without TXA. A total number of 100 patients met all eligibility criteria and were randomly assigned to the groups; 50 to each group, which were homogeneous for age, sex, diagnosis. The intervention group, treated with the standard protocol with the addition of TXA, showed a significant reduction of postoperative edema and increased patient comfort. Based on our findings, we strongly recommend introducing TXA into postoperative treatment protocols in orthognathic surgery for patients without risk factors.

Keywords: Orthognathic surgery, tranexamic acid, postoperative edema, postoperative comfort, maxillofacial surgery, malocclusion.