Microporous Polysaccharide Hemospheres and Seroma Formation After Mastectomy and Axillary Dissection in Rats

Abstract

Objective: Seroma is the most common complication after breast surgery. Several methods have been proposed to prevent seroma, but none of these provided a significant effect. A prolonged wound healing process is the most important cause of seroma. Microporous polysaccharide hemospheres (MPH) are used to achieve hemostasis. They may also accelerate wound healing. In this study, the effects of MPH on seroma formation were investigated.Material and Methods: Female Wistar rats weighing between 200 g and 250 g were used. There were eight rats in each of the control and study groups. Right breast mastectomy and axillary dissection were performed in all rats. While no application was performed after the operation in the control group, MPH was locally applied to the surgical site in the study group. Ten days after the operation, seroma fluid was aspirated and the total volume was recorded. The aspirates were analyzed and tissue samples were obtained from the surgical site.Results: Seroma was significantly lower in the study group (p=0.001). The mean albumin and lactate dehydrogenase levels were significantly lower in the study group (p=0.003). Pathological examination revealed that increase in fibrous tissue was significantly greater in the control group (p=0.032).Conclusion: MPH may reduce seroma after mastectomy.

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

“…In our study, we detected that the effect of reduced seroma occurred with the increase of neovascularisation and granulation tissue, not with the increase of fibrous tissue as in the studies in which sclerosing agents were used such as the study by Wang et al (19) who used light-activated fibrin glue and the study by Egeli et al (20) who used microporous polysaccharide spherules.…”

Effect of topical microporous polysaccharide hemospheres on the duration and amount of fluid drainage following mastectomy: a prospective randomized clinical trial

“…Plant based polysaccharides have been shown to play a positive role in immune stimulation and wound healing via macrophage activation, fibroblast stimulation, and T-cell stimulation [12–17]. In addition to its immunostimulatory effects, MPH particles extract fluid from the blood, swell, and form a gelled matrix concentrating serum proteins, platelets, albumin, thrombin, and fibrinogen; creating a scaffold for the formation of fibrin clot [9, 18]. These characteristics may also help MPH prevent vascular and lymphatic drainage and prevent seroma formation.…”

“…An animal model evaluating topical MPH and seroma formation after mastectomy with axillary dissection showed a significant decrease in seroma volume [18]. Additionally, they demonstrated a reduction in the seroma’s total protein level, albumin concentration, lactate dehydrogenase level, and white blood cell counts; indicating a reduction in the accumulation of inflammatory exudate [18].…”

“…An animal model evaluating topical MPH and seroma formation after mastectomy with axillary dissection showed a significant decrease in seroma volume [18]. Additionally, they demonstrated a reduction in the seroma’s total protein level, albumin concentration, lactate dehydrogenase level, and white blood cell counts; indicating a reduction in the accumulation of inflammatory exudate [18]. Histopathological evaluation demonstrated that the MPH group had decreased fibrous tissue and decreased number of macrophages and fibroblasts compared to the control; interpretation made was that MPH reduced seroma formation by accelerating the wound healing process [18].…”

Successful treatment of a chronic abdominal wall seroma with the polysaccharide 4DryField ® PH − A case report

“…In another study drainage was shown to reduce post-operative hematoma but not seroma formation [10] . In an experimental study in rats polysaccharide powder has been found to prevent seroma formation [11] . However, this was not confirmed clinically yet.…”