Abstract
BackgroundSeroma formation is a frequent complication following radical lymph node dissection (RLND) in patients with metastatic melanoma. Several strategies have been used to prevent fluid accumulation and thereby reduce the duration of postoperative drainage, including fibrin sealants.MethodsThis was a prospective, single-center study in which consecutive patients undergoing surgical treatment of stage III metastatic melanoma by axillary or ilio-inguinal RLND were randomized to receive standard treatment plus fibrinogen/thrombin-coated collagen sealant patch (CSP) or standard treatment alone. The primary endpoint of the study was postoperative duration of drainage.ResultsA total of 70 patients underwent axillary (n = 47) or ilio-inguinal (n = 23) RLND and received CSP plus standard treatment (n = 37) or standard treatment alone (n = 33). Mean duration of drainage was significantly reduced in the CSP group compared with standard treatment (ITT analysis: 20.1 ± 5.1 versus 23.3 ± 5.1 days; p = 0.010). The percentage of patients drainage-free on day 21 was significantly higher in the CSP group compared with the standard treatment group (86% versus 67%; p = 0.049).ConclusionsUse of the tissue sealant resulted in a significant reduction in duration of drainage. Further studies are warranted to confirm these results in different and selected types of lymphadenectomy.
Highlights
Seroma formation is a frequent complication following radical lymph node dissection (RLND) in patients with metastatic melanoma
Axillary RLND in patients with melanoma resulted in a local complication rate of between 25% and 48%, with over half of the observed complications being delayed wound healing secondary to serum collection [1,2]
Thirty-seven patients were randomized to the standard treatment plus collagen sealant patch (CSP) group and 33 were randomized to the control group receiving standard treatment only
Summary
Seroma formation is a frequent complication following radical lymph node dissection (RLND) in patients with metastatic melanoma. Ilioinguinal and axillary dissections have been associated with a number of postoperative complications, ranging from wound infections to skin flap necrosis. These can result in increased hospital costs, reduced quality of life of patients and a delayed return to work and other activities. Closed suction drains require ongoing surveillance and maintenance, restrict patients’ physical activity and delay their return to normal life. They can be associated with complications such as infection or flap necrosis. Effective strategies to reduce the incidence of seroma formation and thereby allow earlier drain removal offer benefits to both patients and surgeons
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
