Topical Tranexamic Acid in Breast Surgery: A Systematic Review and Meta-Analysis of Postoperative Bleeding Outcomes.

Meta-analysis demonstrated a significant reduction in postoperative drain output with topical tranexamic acid (mean difference -16.22 mL; 95% CI: -26.54 to -5.91; p = 0.002).

Seroma rates did not differ significantly between groups (p = 0.26).

Subgroup analysis by procedure type showed numerically greater effects in mastectomy cohorts, with no significant subgroup differences for drain output (p = 0.31) or haematoma (p = 0.19).

No tranexamic acid-related adverse events were reported.