Effect of Fibrinogen and Thrombin Concentrations on Mastectomy Seroma Prevention

Sanders, Richard D.; Goodman, Norman C.; Amiss, L. R.; Pierce, Richard A.; Moore, Margaret E.; Marx, Gerard; Morgan, Raymond F.; Spotnitz, William D.

doi:10.1006/jsre.1996.0082

Cited by 54 publications

(33 citation statements)

References 4 publications

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“…Also, increasing the dose and use of human thrombin and fibrinogen was recommended by many authors. 13,[16][17][18] The cumulative amount of seroma in fibrin glue group in our results showed highly significant reduction compared to the control group. This harmonizes with results obtained by all previously mentioned authors who documented decrease incidence of seroma in their series.…”

Section: The Statistical Analysis Of Received Pre-and Postoperative Dsupporting

confidence: 44%

“…16 Other animal study found that increasing the concentrations of both the fibrinogen and the thrombin components up to a threshold level produced a trend of increasing effectiveness in preventing seroma formation. 17 Burak et al documented that the trial failed to show a significant reduction in the incidence of seromas using bovine thrombin only and recommended to examine combining human thrombin with concentrated fibrinogen in an effort to produce a stronger and more effective sealant. 18 On the light of previous researches, we designed present study where we implemented good randomization of patients and used combination of human thrombin with fibrinogen in a more concentrated dose.…”

Section: The Statistical Analysis Of Received Pre-and Postoperative Dmentioning

confidence: 99%

“…This is in line with results documented by many authors. 6,13,14,16,17,19,20,22 Eunyoung Ko et al documented that fibrin glue use can decrease the drainage duration and overall drain output after breast lumpectomy and axillary dissection in patients undergoing level II or III axillary dissection. 6 Moore et al reported that the application of fibrin sealant following axillary dissection at the time of lumpectomy or modified radical mastectomy can significantly decrease the duration and quantity of serosanguinous drainage.…”

Section: The Statistical Analysis Of Received Pre-and Postoperative Dmentioning

confidence: 99%

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Role of fibrin glue in seroma reduction after modified radical mastectomy

Fawzy¹,

Gaber²,

Farid³

2017

Int Surg J

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INTRODUCTIONBreast cancer is the second leading cause of cancer death among women. The surgical treatment is the best choice for those patients. 1 Since the first mastectomy which was carried out by Halsted in 1882, surgeons have faced several problems such as skin flaps necrosis, wound breakdown, seroma, infection, nerve injuries, lymphedema, phantom breast syndrome and hematoma. Seroma, which is a subcutaneous collection of serous fluid, is a common problem in breast surgery where it develops under the skin flaps during mastectomy or in the axillary dead space after axillary dissection. It usually resolves within a few weeks, so many surgeons view this problem as an unavoidable nuisance rather than a serious complication. 3Seroma formation is the most frequent postoperative complication after breast cancer surgery. Incidence of seroma formation after breast surgery varies between 2.5% and 51%. Although seroma is not life threatening, it can lead to significant morbidity (e.g. flap necrosis, wound dehiscence, predisposes to sepsis, prolonged recovery period, multiple physician visits) and it may delay adjuvant therapy.1 The pathogenesis of seroma has not been fully elucidated. It has been hypothesized that seromas form as an exudate from an acute inflammatory ABSTRACT Background: Seroma is one of the most common morbidity occurring post modified radical mastectomy (MRM). It can delay post-operative initiation of adjuvant therapy. This study was designed to determine the role of fibrin glue spray in reduction of seroma volume and duration after breast surgeries. Methods: A prospective, randomized, controlled study over forty female patients who underwent (MRM) was done. The study cohort was randomized into control group where only conventional drain placement was used and experimental group where double dose of fibrin glue has been sprayed to the axillary and mammary beds plus conventional drain placement. Data regarding the amount of drained fluid in the first post-operative day, hospital stay, length of drain placement, amount and duration of post-operative seroma, number of excised lymph nodes (L. Ns) and pathological results were recorded. Results: No difference in mean age, number of excised L. Ns and rate of post-operative infection between both groups was detected. There was significant reduction in hospital stay time favouring fibrin glue group (p=0.006). Fibrin glue group had a significant reduction in the length of drain placement (p=0.001). The amount of postoperative serous fluid was reduced and the incidence of occurrence of post-operative seroma was (7/20) 35% in control group compared to (1/20) 5% in fibrin glue group giving significant reduction in incidence and amount. Conclusions: Use of fibrin glue sealant during MRM resulted in noticeable and significant decrease of post-operative rate of seroma formation, its amount and the length of drain placement.

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Section: The Statistical Analysis Of Received Pre-and Postoperative Dsupporting

confidence: 44%

Section: The Statistical Analysis Of Received Pre-and Postoperative Dmentioning

confidence: 99%

Section: The Statistical Analysis Of Received Pre-and Postoperative Dmentioning

confidence: 99%

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Role of fibrin glue in seroma reduction after modified radical mastectomy

Fawzy¹,

Gaber²,

Farid³

2017

Int Surg J

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“…The inverse ratio between the seroma volume and the amount of porcine dermal collagen applied to the tissue in our study was also seen in the study of Sanders et al (18) in which fibrinogen and thrombin concentration was used.…”

Section: Discussionsupporting

confidence: 80%

Porcine Dermal Collagen Prevents Seroma Formation After Mastectomy and Axillary Dissection in Rats

Ağalar¹,

Sevinç²,

Aysal³

et al. 2017

Eur J Breast Health

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“…Sanders et al [22] noted that excessive concentration of fibrinogen in fibrin glue may be counterproductive as it may adversely affect wound healing, but in clinical practice it significantly reduces the overall seroma formation, earlier drain removal and reduced length of hospital stay. Other investigators, however, have refuted this effect and reported that neither fibrin sealants for bovine thrombin have any significant effect on reduction of seroma formation and daily drainage [23,24].…”

Section: The Use Of Sealants and Sclerotherapymentioning

confidence: 99%

Seroma Formation after Mastectomy: Pathogenesis and Prevention

Sampathraju

Rodrigues

2010

Indian J Surg Oncol

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Post mastectomy seroma remains an unresolved quandary as the risk factors for its formation have still not been identified. Seromas of the axillary space following breast surgery can lead to significant morbidity and delay in the initiation of adjuvant therapy. Various techniques and their modifications have been practiced and published in English literature, but there seems to be no consensus. In this article, all aspects of seroma formation from pathogenesis to prevention including drug therapies have been discussed.

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Effect of Fibrinogen and Thrombin Concentrations on Mastectomy Seroma Prevention

Cited by 54 publications

References 4 publications

Role of fibrin glue in seroma reduction after modified radical mastectomy

Role of fibrin glue in seroma reduction after modified radical mastectomy

Porcine Dermal Collagen Prevents Seroma Formation After Mastectomy and Axillary Dissection in Rats

Seroma Formation after Mastectomy: Pathogenesis and Prevention

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