Fibrin Glue Sealant: An Effective Modality to Mitigate Postoperative Seroma After Modified Radical Mastectomy.

Abstract

Introduction Modified radical mastectomy is a common modality used in treating breast cancer and often presents a series of post-operative challenges. Seroma formation is the most common complication with no single method shown to be reliably effective against it. Fibrin glue is one such modality. There is a paucity of studies describing the utility of fibrin glue to prevent seroma formation. Aim To evaluate the effect of intraoperative application of fibrin glue sealant on drain output and seroma formation in patients undergoing modified radical mastectomy by comparing outcomes between the two groups. Method This is a prospective observational study. Fibrin glue application was done intra-operatively prior to closure in one group. Standard closure procedures with drain placement were undertaken in another group and their outcomes were analyzed for both groups. Results Drain output on postoperative day 1 (POD 1) as well as total drain output were recorded for both groups and the difference in mean was found to be significant (p<<0.05 and 0.049, respectively. Distribution of patients according to the volume of seroma formation was done; this difference of means was also found to be significant (p=0.004). Further, the difference of mean for the number of days the drain was in-situ was found to be significant. Conclusion Fibrin sealant used during modified radical mastectomy closures decreased the rates and volumes of seroma formation. This led to quicker drain removals and less patient discomfort.