Effect of autologous fibrin glue on seroma reduction after modified radical mastectomy for breast cancer: A randomized controlled trial

Abstract

Introduction Breast cancer stands out as the second most common cancer in the world with incidence 35.1% of all malignancies among females in Egypt. Fluid build-up after breast surgery is still the most annoying complication which leads to worse outcome. We aimed to evaluate whether autologous fibrin glue might lessen the formation of seroma following modified radical mastectomy. Methods This was a randomized controlled trial designed to configure the effect of autologous fibrin glue given in the study group using the drain in comparison to a control group who received the drain only; seroma volume was calculated every 24 h. For all of the cases. The drains were removed when the daily drainage was less than 30 ml for 3 consecutive days. Results We recruited 30 patients to each of the two groups. Age, pathology, breast cancer stage, number of lymph nodes and tumour size did not differ significantly between groups. A comparison of the median days to drain removal showed 8 days reduction in median days to drain removal compared in the intervention group (7 days) than the control (15 days). The patients in the fibrin glue group had a significantly lower cumulative drain output volume (mean ± SD of 505,6 ± 209,3 ml) than those in the control group (1674.1 ± 1 373,8 ml). Conclusions Autologous fibrin glue significantly decrease seroma formation post-modified radical mastectomy.

Impact of microporous polysaccharide haemostatic agent on patients undergoing mastectomy or axillary dissection on seroma formation and timing of drain removal

“…Other studies have explored use of tetracycline, which is a sclerosing agent and demonstrate mixed results with respect to its efficacy in reducing seroma formation. 6 Systemic pharmaceutical agents such as somatostatin analogues octreotide and lanreotide have also been explored as candidates to reduce secretions which promote seroma formation with mixed results. 7 It is difficult to draw overall conclusion due to significant differences in methodology, sample size, clinical and surgical diversity in ways in which these agents have been explored for preventing seroma formations after major surgery.…”

“…8 Tranexamic acid has been shown to decreased haematoma development after breast cancer surgery but had no impact on seroma formation in one study and was associated with decreased risk of haematoma and seroma formation in another study. 6,16 Mahmood In breast cancer surgery, radical and extended mastectomies are performed less because of earlier detection through screening and trials showing excellent oncological outcomes with breast conserving surgery. Smaller surgical resections will have less residual dead space.…”

Our experience with Endoscopic Transnasal Transsphenoid Resection of Pituitary Adenomas

“…Just before the final 2 minutes of administration into the flaps, we added 2 ml of 50 mg/mL calcium gluconate. 24 A binostril transnasal transsphenoidal approach was performed. The nose was sterilized with betadine, and adrenaline/saline with dilution 1/100000 was injected submucosally then a nasoseptal Hadad flap was raised bilaterally until exposure of the anterior table of the sphenoid sinus bilaterally.…”