Abstract
IntroductionPost-mastectomy seromas are a common problem in modern oncological surgery. Occurrence rates of up to 59% have been reported in the literature. High-risk patients, that is, those who have received previous surgeries, radiation or chemotherapy, present a particular challenge. Several surgical techniques, including progressive tension suture application, have shown promise. Noninvasive measures such as fibrin-based adhesives have thus far not been able to prevent seroma occurrence effectively. A recent study using a lysine-derived urethane adhesive named TissuGlu®, however, showed promising results in patients after abdominoplasty.Case presentationWe used TissuGlu® to treat a high-risk 64-year-old female patient with a history of breast cancer and severe post-mastectomy seroma. The postsurgical period showed successful seroma suppression, without any adverse effects or complications.ConclusionsThis type of adhesive should be evaluated as an alternative, less-invasive option for preventing seroma in patients after a mastectomy.
Highlights
Post-mastectomy seromas are a common problem in modern-day oncological surgery
Patients with seromas experience effects caused by fluid buildup, such as prolonged wound healing, increased susceptibility to infection, necrosis, persistent pain and an overall decrease in postsurgical quality of life
A plethora of approaches have been evaluated to reduce the incidence of seroma formation but, apart from placing drains, no fundamental progress has been made [2,3,4]
Summary
Post-mastectomy seromas are a common problem in modern-day oncological surgery. Complication rates of up to 59% [1] have been reported in the literature. In 2012 (20 years post mastectomy), our patient had her first revision surgery after local thoracic wall recurrence. Standard postsurgical protocols for drain removal were followed and her wound healing was adequate. Two-week and four-week follow-up visits showed that our patient had adequate wound healing without signs of a seroma. Because no seroma formation was documented in the postsurgical period, the application of TissueGlu® was deemed successful. This product may provide a simple solution to the problem of postsurgical seroma formation in patients who have had a mastectomy. Future studies should evaluate whether these will be offset by the potential cost of additional revision surgeries and increased number of postsurgical follow-ups often required in patients with a seroma
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