{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T11:46:32Z","timestamp":1775994392829,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2026,3]]},"abstract":"ABSTRACT<\/jats:title>\n \n Introduction<\/jats:title>\n \n Tranexamic acid (\n TXA<\/jats:styled-content>\n ), an antifibrinolytic agent, has demonstrated efficacy in reducing perioperative bleeding across multiple surgical interventions. While increasingly utilized in breast reconstruction, evidence regarding its role in free flap procedures remains limited and inconsistent. This study evaluates the impact of preoperative\n TXA<\/jats:styled-content>\n administration on postoperative outcomes in free flap breast reconstruction.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A retrospective cohort study was performed using the\n TriNetX<\/jats:styled-content>\n research network to identify patients undergoing free flap breast reconstruction. Patients receiving preoperative\n TXA<\/jats:styled-content>\n were compared with those who did not. Propensity score matching was applied to balance demographic and clinical variables. Primary outcomes included hematoma, seroma, bleeding, venous thrombosis, and flap loss.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 20,778 patients, 524 (2.5%) received preoperative\n TXA<\/jats:styled-content>\n . After 1:1 propensity score matching, 524\n TXA<\/jats:styled-content>\n patients were compared with 524 controls. Hematoma rates were significantly higher in the\n TXA<\/jats:styled-content>\n group (21.2% vs. 15.3%,\n RR<\/jats:styled-content>\n 0.72, 95%\n CI<\/jats:styled-content>\n 0.55\u20130.94,\n p<\/jats:italic>\n \u2009=\u20090.01). Seroma occurred more frequently in\n TXA<\/jats:styled-content>\n patients (23.2% vs. 18.9%) but was not statistically significant (\n p<\/jats:italic>\n \u2009>\u20090.05). Postoperative bleeding, venous thrombosis, and flap loss rates were comparable. Intraoperative hemorrhage occurred exclusively in the non\u2010\n TXA<\/jats:styled-content>\n group (\u2264\u20091.9% vs. 0%,\n p<\/jats:italic>\n \u2009=\u20090.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Contrary to prior reports, preoperative\n TXA<\/jats:styled-content>\n use in free flap breast reconstruction was associated with a higher incidence of hematoma, without significant reduction in the rate of other complications.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/micr.70201","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:29:52Z","timestamp":1773005392000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative Tranexamic Acid Use in Free Flap Breast Reconstruction: A Propensity\u2010Matched Analysis of Postoperative Outcomes"],"prefix":"10.1002","volume":"46","author":[{"given":"Ramin","family":"Shekouhi","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery Louisiana StateUniversity Health Sciences Center New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandon","family":"Byrd","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery Louisiana StateUniversity Health Sciences Center New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Branstetter","sequence":"additional","affiliation":[{"name":"College of Medicine Louisiana State University Health Sciences Center New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6139-8708","authenticated-orcid":false,"given":"Harvey","family":"Chim","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery Louisiana StateUniversity Health Sciences Center New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00266\u2010025\u201004772\u20105"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.70046"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clbc.2025.01.011"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.21037\/abs-23-46"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2025.03.022"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.GOX.0000898324.16683.8e"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010020\u201006241\u20109"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clbc.2025.07.003"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.21037\/gs.2018.03.10"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/prs.0000000000010071"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/tbj.13810"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00238\u2010022\u201002027\u2010z"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/gox.0000000000004693"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800810621"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta17100"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2024.09.085"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/22925503221120549"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1055\/a\u20102632\u20102621"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.06.001"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.10725"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/gox.0000000000006457"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.7205\/milmed\u2010d\u201014\u201000479"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/prs.0000000000006967"}],"container-title":["Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.70201","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/micr.70201","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.70201","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T10:58:51Z","timestamp":1775991531000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/micr.70201"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,26]]},"references-count":23,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1002\/micr.70201"],"URL":"https:\/\/doi.org\/10.1002\/micr.70201","archive":["Portico"],"relation":{},"ISSN":["0738-1085","1098-2752"],"issn-type":[{"value":"0738-1085","type":"print"},{"value":"1098-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,26]]},"assertion":[{"value":"2025-10-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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