Abstract
Background and Objectives. This study was designed to determine the effectiveness of fibrin glue plus conventional drain placement versus conventional drain placement in the prevention of seromas after breast procedures. Among methods employed to reduce seroma magnitude and duration, fibrin glue has been proposed in numerous studies, with controversial results. Design and Setting. A prospective, randomized, controlled study of subjects who were randomized into control and experimental groups was conducted. Methods. Collected data included age, surgeon, medical and surgical history, comorbidities, procedure performed, number of axillary nodes, number of positive axillary nodes collected, final pathologic diagnosis, cancer stage, hospital stay, postoperative day of drain removal, complications, incidence of seroma formation, interval to seroma resolution, and number of postoperative visits. Results. Analysis of 60 patients showed similarly matched groups. Seroma formation rate was 24.1% in the control group and 16.1% in the fibrin glue group. The rate of wound complications was similar. Conclusions. Although use of fibrin sealant resulted in a nonsignificant decrease in seroma formation rate compared with that of drain placement, the higher cost and cumbersome technique tend to indicate that there is no advantage to using fibrin glue over drain placement with the technique described.
Highlights
Ever since mastectomy was first carried out by Halsted in 1882, surgeons have faced several problems such as necrosis of the skin flaps, breakdown of the wound, hematoma, seroma, and infection [1]
Use of fibrin sealant resulted in a nonsignificant decrease in seroma formation rate compared with that of drain placement, the higher cost and cumbersome technique tend to indicate that there is no advantage to using fibrin glue over drain placement with the technique described
The purpose of this study was to evaluate the efficacy of fibrin glue plus closed suction drain over closed suction drain placement in preventing seroma formation after modified radical mastectomy, and lumpectomy with axillary node dissection for the treatment of breast cancer
Summary
Ever since mastectomy was first carried out by Halsted in 1882, surgeons have faced several problems such as necrosis of the skin flaps, breakdown of the wound, hematoma, seroma, and infection [1]. Seroma, a subcutaneous collection of serous fluid, is a common problem in breast surgery As it usually resolves within a few weeks, many surgeons view this problem as an unavoidable nuisance rather than a serious complication [1, 2]. This study was designed to determine the effectiveness of fibrin glue plus conventional drain placement versus conventional drain placement in the prevention of seromas after breast procedures. Among methods employed to reduce seroma magnitude and duration, fibrin glue has been proposed in numerous studies, with controversial results. Use of fibrin sealant resulted in a nonsignificant decrease in seroma formation rate compared with that of drain placement, the higher cost and cumbersome technique tend to indicate that there is no advantage to using fibrin glue over drain placement with the technique described
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