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Effects of local tranexamic acid on bleeding during rhytidectomy and post operative complication: randomized, controlled, single-blind trial

This protocol outlines a single-blind, randomized controlled trial at King Abdulaziz University Hospital designed to evaluate whether adding local tranexamic acid to tumescent solution during rhytidectomy reduces bleeding-related complications compared to tumescent solution alone.

Original authors: Abdulaziz Saud Alenazi, Ahmed M Alarfaj, Amani A Obeid, Abdulaziz Alrabiah, Osama Alkaoud, Abdulaziz Alderaywsh, Leena R . Baghdadi

Published 2026-07-01

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CC BY 4.0

Original authors: Abdulaziz Saud Alenazi, Ahmed M Alarfaj, Amani A Obeid, Abdulaziz Alrabiah, Osama Alkaoud, Abdulaziz Alderaywsh, Leena R . Baghdadi

Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). ✨ This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer

The Big Picture: A "Stop the Leak" Experiment

Imagine you are fixing a leaky roof (the surgery). Even if you patch it perfectly, water (blood) can still seep out during the repair, causing a mess (hematoma/bruising) that takes a long time to clean up and might damage the roof tiles (skin).

This study is a plan to test a new "super-glue" ingredient called Tranexamic Acid (TXA). The researchers want to see if mixing this ingredient into the standard numbing spray used during face-lifts (rhytidectomy) stops the bleeding better than the spray alone.

The Players and the Setting

The Location: King Abdulaziz University Hospital in Riyadh, Saudi Arabia.
The Players: Adults (35+) getting a cosmetic face or neck lift.
The Goal: To see if adding TXA reduces the amount of blood lost during surgery and the amount of bruising and swelling afterward, without causing new problems.

How the Experiment Works (The "Blind Taste Test")

Think of this like a blind taste test for two different soups. The diners (patients) won't know which soup they are getting, but the chefs (surgeons) will know.

The Setup: The researchers will recruit 32 people. They will flip a digital coin to split them into two equal teams (16 in each).
Team A (The Control Group): They get the "Standard Soup." This is the usual numbing spray doctors use (lidocaine and epinephrine) to stop bleeding and numb the area.
Team B (The Intervention Group): They get the "Special Soup." This is the exact same numbing spray, but with a secret ingredient added: Tranexamic Acid (TXA).
- What is TXA? Think of it as a "fibrin glue" for your blood. Normally, your body has a mechanism that breaks down blood clots (like a cleanup crew). TXA tells the cleanup crew to take a break, letting the blood clot stay strong and stop the leak faster.
The "Blind" Part: The patients are "blind" to which soup they got. They don't know if they received the special ingredient or just the standard mix. This ensures their expectations don't influence how they report their pain or swelling.

What Are They Measuring? (The Scorecard)

The researchers are keeping a very close eye on three main things:

The "Sponge Count" (Blood Loss): During surgery, they will weigh the sponges and measure the suction canisters to see exactly how much blood was lost.
The "Puffy Face" (Swelling & Bruising): After surgery, on days 1, 6, and 9, they will check how puffy and bruised the face is.
- Subjective: The patient and doctor will rate it like a weather report (Mild, Moderate, Severe).
- Objective: They will use a special 3D camera (Vectra) to take pictures and measure the exact volume of swelling, like measuring the water level in a tank.
The "Safety Check" (Complications): They are watching for bad side effects, such as:
- Skin dying (necrosis).
- Big blood clots under the skin (hematomas).
- Blood clots in the legs or lungs (thromboembolism).
- Infections or allergic reactions.

The Rules of the Game

Who can play? Healthy adults over 35 getting a face lift.
Who is out? People who already have blood clotting issues, those taking blood thinners (like aspirin), or people with a history of seizures or blood clots.
The Timeline:
- Before: Check-up and signing papers.
- During: The surgery happens, and the special spray is injected under the skin.
- After: Check-ups on Day 1, Day 6, and Day 9, plus a phone call on Day 30.

Why Do This?

Currently, doctors use the standard spray, but some are starting to add TXA because it seems to work in other surgeries. However, there isn't a strict "gold standard" proof (a Randomized Controlled Trial) specifically for face lifts yet.

This study is the "proof of concept." If the "Special Soup" (TXA) works, it could become a simple, cheap, and easy way to make face lifts safer and help patients recover faster with less bruising. If it doesn't work, or causes too many side effects, doctors will know to stick with the standard spray.

The Bottom Line

This paper is a recipe and a plan for a clinical trial. It hasn't finished cooking yet (recruitment started in 2024 and ends in 2026), so there are no final results to report yet. It simply outlines how the researchers intend to test if adding a blood-clotting helper to the numbing spray makes face-lift surgeries cleaner and safer.