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Comparison of the Effect of Dexamethasone and Tranexamic Acid, Separately or in Combination on Post-Rhinoplasty Edema and Ecchymosis

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  • Rhinoplasty
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Abstract

Background

Dexamethasone and tranexamic acid are used to decrease post-rhinoplasty periorbital edema and ecchymosis. We compared the impact of each medication separately or in combination in this regard.

Methods

A prospective, randomized triple-blinded study was undertaken on 60 patients who underwent primary open rhinoplasty. They were divided into four groups: Group D (n = 15) received 8 mg dexamethasone, group T (n = 15) received 10 mg/kg tranexamic acid, group DT (n = 15) received both 8 mg dexamethasone and 10 mg/kg tranexamic acid, and group P (n = 15) received neither medication and served as the placebo control group. The medications were given intravenously (IV) 1 h before and three doses every 8 h postoperatively. Digital photographs were taken on the first, third and seventh postoperative days. One expert examiner blinded to the study evaluated the periorbital edema and ecchymosis on a scale of 0–4. Periorbital edema and ecchymosis were examined in all groups.

Results

In group D, group T and group DT, periorbital edema and ecchymosis ratings were significantly lower compared with the control group (p < 0.01). No statistically significant difference was seen in preventing or decreasing both periorbital edema and ecchymosis among group D, group T and group DT.

Conclusion

Tranexamic acid and dexamethasone, separately or in combination, had similar effects in reducing periorbital edema and ecchymosis in open rhinoplasty. Combined application did not show a significantly higher beneficial effect in this regard.

Level of Evidence III

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Acknowledgement

The authors express their gratitude to Neda Amani, Ahmad Heidari and Fatemeh Mehravar for technical helps. The authors would like to acknowledge the Clinical Research Development Unit (CRDU) of 5 Azar Hospital at Golestan University of Medical Sciences for consultation.

Author information

Author notes

  1. Mohammad Mehdizadeh and Alireza Ghassemi have contributed equally to this work.

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran

    Mohammad Mehdizadeh

  2. Department of Oral and Maxillofacial Surgery, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran

    Mohammad Mehdizadeh & Hosein Ghanepur

  3. Consultant Oral and Maxillofacial Surgeon, Klinikum Lippe, Academic Hospital of the University of Göttingen, Detmold, Germany

    Alireza Ghassemi

  4. Medical Faculty University RWTH Aachen, Aachen, Germany

    Alireza Ghassemi

  5. Department of Plastic Surgery, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran

    Mohammad Khakzad

  6. Department of Anesthesiology and Intensive Care, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran

    Mehrafza Mir

  7. Department of Medical Biotechnology, School of Advanced Medical Technologies, Tehran University of Medical Sciences, Tehran, Iran

    Leili Nekoohesh

  8. Department of Pharmacology and Toxicology, Babol University of Medical Sciences, Babol, Iran

    Aliakbar Moghadamnia

  9. Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran

    Ali Bijani

  10. Department of Biostatistics, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran

    Zahra Mehrbakhsh

  11. Department of Oral and Maxillofacial Surgery, 5 Azar Hospital, Golestan University of Medical Sciences, 5 Azar Street, Gorgan, Iran

    Hosein Ghanepur

Authors
  1. Mohammad Mehdizadeh
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  2. Alireza Ghassemi
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  9. Hosein Ghanepur
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Corresponding author

Correspondence to Hosein Ghanepur.

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Ethics statement/confirmation of patients’ permission

We have no financial interest and we did not have any financial or material support concerning this study. All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Mehdizadeh, M., Ghassemi, A., Khakzad, M. et al. Comparison of the Effect of Dexamethasone and Tranexamic Acid, Separately or in Combination on Post-Rhinoplasty Edema and Ecchymosis. Aesth Plast Surg 42, 246–252 (2018). https://doi.org/10.1007/s00266-017-0969-x

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  • DOI: https://doi.org/10.1007/s00266-017-0969-x

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