Prevention of Seroma After Inguinal Lymph Node Dissection by TachoSil Application: A Pilot Study

Abstract

IntroductionInguinofemoral lymph node dissection is the standard of care for stage III melanoma of the lower extremity with regional lymph node metastasis. Seroma is one of the most common and burdensome postoperative complications after inguinofemoral lymph node dissection. Many measures have been taken to reduce the development of seroma, none with definite success. Patients and MethodWe reviewed the effects of TachoSil patch sealing on the formation of seroma. In the present prospective one-arm single-stage pilot study, 20 patients were scheduled to undergo inguinofemoral lymph node dissection (ILND) with TachoSil application and placement of a standard closed suction drain (CSD) to investigate the effects of TachoSil on the formation of seroma. The presence of seroma after a standard protocol, which included CSD removal 3 days after surgery and the number of aspirations after CSD removal were recorded. In addition, the number and severity of surgical site infections were recorded. ResultsA preplanned futility analysis after the inclusion of 11 patients showed that all patients developed postoperative seroma. The median number of aspirations after CSD removal was 3. This resulted in premature termination of the study. In addition, 10 of the 11 patients developed a surgical site infection. DiscussionNo evidence of a positive effect of TachoSil application on seroma formation after ILND was seen in the present study, and 10 of the 11 patients developed a surgical site infection. ILND remains a surgical procedure with a high incidence of postoperative complications, including seroma. New morbidity-reducing strategies are eagerly awaited, because the TachoSil patches do not seem to have a role in the management of seroma prevention after ILND.