Hydroxyethyldimethyldihydropyrimidine as the drug of choice for the prevention of paraprosthetic seromas in breast reconstructive surgery: A retrospective study

Abstract

Background. The most common complication in breast reconstructive surgery using silicone implants after radical treatment for neoplasms is long-lasting lymphorrhea after the resection stage, which threatens the development of postoperative complications. The improvement of the surgical technique of reconstructive and reconstructive operations on the mammary gland does not allow to exclude tissue injury with the formation of a cavity, into which foreign materials (mesh endoprosthesis, silicone implant) are subsequently installed, which are one of the main factors in the formation of seroma. Optimization of pharmacotherapy support in the early postoperative period allows to minimize the manifestations of lymphorrhea and serogenesis, to improve the quality of life of patients.
 Materials and methods. A retrospective analysis of the treatment of 75 patients who underwent reconstructive breast surgery in the combined and complex treatment of breast cancer was carried out. The patients were divided into two representative groups depending on the intake of hydroxyethyldimethyldihydropyrimidine, a pyrimidine-type drug. At the same time, in one of the groups, hydroxyethyldimethyldihydropyrimidine was prescribed in accordance with the instructions for the use of this drug in order to optimize the wound process and prevent purulent-inflammatory disorders in the early postoperative period.
 Results. In group 1 patients taking hydroxyethyldimethyldihydropyrimidine, there was a decrease in the duration of lymphorrhea by 2 times from 5.4 days (group 2) to 2.6 days after surgery. In addition, no cases of paraprosthetic seroma formation were recorded in group 1, while puncture management of paraprosthetic lymphocele was performed in 16 patients of group 2.
 Conclusion. The inclusion of hydroxyethyldimethyldihydropyrimidine in the pharmacotherapy of maintenance in the early postoperative period in the study group of patients made it possible to significantly reduce the duration and volume of lymphorrhea, remove trapping drains from the paraprosthetic space earlier, prevent the formation of paraprosthetic seroma and the development of other, more formidable complications (suppuration, capsular contracture, silicone implant extrusion).