DOI: https://dx.doi.org/10.18203/2349-2902.isj20172579
Published: 2017-06-22

Role of fibrin glue in seroma reduction after modified radical mastectomy

Ahmed Fawzy, Ahmed Gaber, Abd Al Monem Farid

Abstract


Background: Seroma is one of the most common morbidity occurring post modified radical mastectomy (MRM). It can delay post-operative initiation of adjuvant therapy. This study was designed to determine the role of fibrin glue spray in reduction of seroma volume and duration after breast surgeries.

Methods: A prospective, randomized, controlled study over forty female patients who underwent (MRM) was done. The study cohort was randomized into control group where only conventional drain placement was used and experimental group where double dose of fibrin glue has been sprayed to the axillary and mammary beds plus conventional drain placement. Data regarding the amount of drained fluid in the first post-operative day, hospital stay, length of drain placement, amount and duration of post-operative seroma, number of excised lymph nodes (L. Ns) and pathological results were recorded.

Results: No difference in mean age, number of excised L. Ns and rate of post-operative infection between both groups was detected. There was significant reduction in hospital stay time favouring fibrin glue group (p=0.006). Fibrin glue group had a significant reduction in the length of drain placement (p=0.001). The amount of post-operative serous fluid was reduced and the incidence of occurrence of post-operative seroma was (7/20) 35% in control group compared to (1/20) 5% in fibrin glue group giving significant reduction in incidence and amount.

Conclusions: Use of fibrin glue sealant during MRM resulted in noticeable and significant decrease of post-operative rate of seroma formation, its amount and the length of drain placement.


Keywords


Fibrin glue, Modified radical mastectomy, Seroma

Full Text:

PDF

References


Hashemi E, Kaviani A, Najafi M, Ebrahimi M, Hooshmand H, Montazeri A. Seroma formation after surgery for breast cancer. World J Surg Oncol. 2004;2(1):44.

Aitken DR, Minton JP. Complications associated with mastectomy. Surg Clinic North America. 1983;63(6):1331-52.

Pogson CJ, Adwani A, Ebbs SR. Seroma following breast cancer surgery. Eu J Surg Oncol. 2003;29(9):711-7.

Srivastava V, Basu S, Shukla VK. Seroma formation after breast cancer surgery: what we have learned in the last two decades. J breast cancer. 2012;15(4):373-80.

Oertli D. Axillary lymphadenectomy. Chirurg. 2000;78:196-202.

Ko E, Han W, Cho J, Lee JW, Kang SY, Jung SY, et al. Fibrin glue reduces the duration of lymphatic drainage after lumpectomy and level II or III axillary lymph node dissection for breast cancer: a prospective randomized trial. J Korean Med Sci. 2009;24(1):92-6.

Kuroi K, Shimozuma K, Taguchi T, Imai H, Yamashiro H, Ohsumi S, et al. Evidence-based risk factors for seroma formation in breast surgery. Jap J Clin Oncol. 2006;36(4):197-206.

Sampathraju S, Rodrigues G. Seroma formation after mastectomy: pathogenesis and prevention. In J Surg Oncol. 2010;1(4):328-33.

Lee JC, Teitelbaum J, Shajan JK, Naram A, Chao J. The effect of fibrin sealant on the prevention of seroma formation after post bariatric abdominoplasty. Can J Plast Surg. 2012;20(3):178-80.

Cha HG, Kang SG, Shin HS, Kang MS, Nam SM. Does fibrin sealant reduce seroma after immediate breast reconstruction utilizing a latissimus dorsi myocutaneous flap? Arch Plast Surg. 2012;39(5): 504-8.

Canonico S. The use of human fibrin glue in the surgical operations. Acta Biomed. 2003;74(2):21-5.

Christodoulakis M, Sanidas E, de Bree E, Michalakis J, Volakakis E, Tsiftsis D. Axillary lymphadenectomy for breast cancer-the influence of shoulder mobilisation on lymphatic drainage. Eur J Surg Oncol. 2003;29:303-5.

Moore M, Burak WE, Nelson E, Kearney T, Simmons R, Mayers L, et al. Fibrin sealant reduces the. duration and amount of fluid drainage after axillary dissection: a randomized prospective clinical trial. J Am Coll Surg. 2001;192(5):591-9.

Moore MM, Freeman MG. Fibrin sealant in breast surgery. J Long Term Eff Med Implants. 1998;8:133-42.

Carless PA, Henry DA. Systematic review and meta-analysis of the use of fibrin sealant to prevent seroma formation after breast cancer surgery. Br J Surg. 2006;93:810-9.

Eroglu E, Oral S, Unal E, Kalaycl M, Oksiiz O, Tilmaz M. Reducing seroma formation with fibrin glue in an animal mastectomy model. Eu J Surg Oncol. 1996;22:137-9.

Sanders RP, Goodman NC, Amiss Jr LR, Pierce RA, Moore MM, Marx G, et al. Effect of fibrinogen and thrombin concentrations on mastectomy seroma prevention. J Surg Res. 1996;61(1):65-70.

Burak WE, Goodman PS, Young DC, Farrar WB. Seroma formation following axillary dissection for breast cancer: risk factors and lack of influence of bovine thrombin. J Surg Oncol. 1997;64(1):27-31.

Jain PK, Sowdi RA, Anderson DG, MacFie J. Randomized clinical trial investigating the use of drains and fibrin sealant following surgery for breast cancer. British J Surg. 2004;91:54-60.

Tejler G, Aspegren K. Complications and hospital stay after surgery for breast cancer: a prospective study of 385 patients. Br J Surg. 1985;72(7):542-4.

Gioffrè FM, Mezzasalma F, Manganaro T, Pakravanan H, Cogliandolo A. The use of fibrin glue in the surgery of breast carcinoma. G chir. 1992;14(4-5):239-41.

Jee JC, Teitelbaum J, Shajan JK, Naram A, Chao J. The effect of fibrin sealant on the prevention of seroma formation after post bariatric abdominoplasty. Can J Plast Surg. 2012;20(3):178-80.

Tasinnato R, Godina M, Griggio L. Prevention of axillary lymphoma in patients with lymphadenectomy for surgical acne breast cancer. The talc. 1993;49:479-84.

Tirelli C, Pantano FP, Morucci R. The seieromi in the breast of the breast. New Press Baxter. 2004;1(1):18.

Ruggiero R, Procaccini E, Gili S, Cremone C, Parmeggiani D, Conzo G, et al. New trends on fibrin glue in seroma after axillary lymphadenectomy for breast cancer. G Chir. 2009;30(6/7):306-10.

Miri Bonjar MR, Maghsoudi H, Samnia R, Saleh P, Parsafar F. Efficacy of fibrin glue on seroma formation after breast surgery. Int J Breast Cancer. 2012;2012:7.

Gilly FN, François Y, Sayag-Beaujard AC, Glehenb O, Brachetb A, Vignala AJ. Prevention of lymphorrhea by means of fibrin glue after axillary lymphadenectomy in breast cancer: prospective randomized trial. Eur Surg Res. 1998;30:439-43.

Langer S, Guenther JM, DiFronzo LA. Does fibrin sealant reduce drain output and allow earlier removal of drainage catheters in women undergoing operation for breast cancer? Am Surg. 2003;69(1):77-81.

Moore MM, Nguyen DH, Spotnitz WD. Fibrin sealant reduces serous drainage and allows for earlier drain removal after axillary dissection: a randomized prospective trial. Am Surg. 1997;63:97-102.

Cipolla C, Fricano S, Vieni S, Graceffa G, Licari G, Torcivia A et al. Does the use of fibrin glue prevent seroma formation after axillary lymphadenectomy for breast cancer? a prospective randomized trial in 159 patients. Surg Oncol. 2010;101(7):600-3.

Vaxman F, Kolbe A, Stricher F, Zund D, Volkmar P, Gros D et al. Does fibrin glue improve drainage after axillary lymph node dissection? Prospective and randomized study in humans. Eur Surg Res. 1995;27(5):346-52.

Dinsmore RC, Harris JA, Gustafson RJ. Effect of fibrin glue on lymphatic drainage after modified radical mastectomy: a prospective randomized trial. Am Surg. 2000; 66(10):982-5.