Seroma Formation in Rat Latissimus Dorsi Resection in the Presence of Biologics

Hurwitz, Zachary M.; Ignotz, Ronald A.; Rowin, Craig; Freniere, Brian B.; Lalikos, Janice F.; Dunn, Raymond M.

doi:10.1097/sap.0000000000000085

Cited by 6 publications

(5 citation statements)

References 25 publications

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“…A seroma formation model in the rat after mastectomy was described in 1992 by Harada et al; however, we consider the incision placed on the anterior half of the thorax too bothersome for the rats. Kulber et al recorded a 90% rate of seroma formation after excising the latissimus dorsi muscle through an incision placed in the midaxillary line, while another group recorded a 74% seroma rate when excising the latissimus dorsi muscle and performing axillary lymphadenectomy through a posterior midline incision of the thorax . Alternatively, scraping the inner surface of the skin flap for lymphovascular disruption has also been described. , Only the combination of the aforementioned techniques (i.e., the latissimus dorsi excision with lymphadenectomy and scraping of the inner surface of the flap) allowed us to obtain a 100% reliable rate of bilateral postoperative seroma, which then served as a model to investigate the treatment benefits of nanoparticle treatment (Figure ).…”

Section: Resultsmentioning

confidence: 99%

“…First, a seroma model was developed by combining the techniques reported in the literature. ,,− Starting from the model described by Kulber et al, a bilateral model was envisioned: an incision was placed in the posterior axillary line, the cutaneous maximus and latissimus dorsi muscles were excised, and additional axillary lymphadenectomy was undertaken. The undersurface of the skin flap was scraped with a scalpel as described by Chung et al After hemostasis was achieved, the skin was closed with interrupted mattress sutures (Figure ).…”

Section: Materials and Methodsmentioning

confidence: 99%

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Mixed Metal Oxide Nanoparticle Formulations for the Treatment of Seroma

Leşe

Tsai

Matter

et al. 2021

ACS Biomater. Sci. Eng.

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Seroma formation is a well-recognized postoperative complication for many plastic and general surgical procedures. Although various tissue adhesives and substances have been used in an effort to treat seroma formation, no therapies have been established clinically. Recently, the nano-bridging phenomenon has been introduced as a promising approach to achieve tissue adhesion and strong closure of deep skin wounds in rats. The present study seeks to assess the potential of nano-bridging beyond skin wounds in a rat model of seroma. Seromas were induced in 20 Lewis rats through bilateral axillary lymphadenectomy, excision of the latissimus dorsi and cutaneous maximus muscles, and disruption of dermal lymphatics. On postoperative day (POD) 7, the seroma was aspirated on both sides. A bioactive nanoparticle (NP) suspension based on zinc-doped strontium-substituted bioglass/ceria nanoparticles (NP group) or fibrin glue (fibrin group) was injected into the right seroma cavity, while the left side was left untreated. On POD 14, the NP group showed complete remission (no seromas at all), while the fibrin group recorded a reduction of only 63% in the seroma fluid volume. The NPs exerted local antiinflammatory and neo-angiogenic effects, without any detectable systemic changes. Moreover, the ceria levels recorded in the organs did not surpass the background level, indicating that the nanoparticles stayed at the site of application. This study is a promising first example demonstrating the ability of inorganic nanoparticle formulations to reduce seroma formation in a rat model, without any detectable systemic adverse effects. These results emphasize the potential of nanotechnological solutions in the therapeutic management of seroma in the clinical setting.

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Section: Resultsmentioning

confidence: 99%

Section: Materials and Methodsmentioning

confidence: 99%

Mixed Metal Oxide Nanoparticle Formulations for the Treatment of Seroma

Leşe

Tsai

Matter

et al. 2021

ACS Biomater. Sci. Eng.

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“…Given the relatively low incidence of seroma with the mastectomy technique, we chose to carry out a different surgical model. To produce seroma formation, we performed a LDM harvest as inspired from scientific literature [13,26]. Our model associating LDM harvest, removing of axillary nodes and subcutaneous scarifications presents the great advantage of providing reliably seroma as 100% of the operated rats presented seroma in large quantity when no prevention was carried out.…”

Section: Discussionmentioning

confidence: 99%

“…Difficulty in TA development lies in the absence of a defined experimental protocol to objectively and comprehensively evaluate a method of seroma prevention. The current models described in the literature focus essentially on the production or not of seroma with iterative punctures, and the evaluation of morbidity is limited to histological analysis [13], [22][23][24][25][26]. Moreover, the animal model mostly described is based on a mastectomy in rats, as described by Lindsey and Harada [22,23].…”

Section: Introductionmentioning

confidence: 99%

Development of Experimental Animal Model and Methodology for Evaluation of a Seroma Prevention Approach

2023

J Surg

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Background: seroma is a frequent complication after routine procedures such as mastectomy or latissimus dorsi flap harvesting. Despite multiple attempts to find preventive and curative solutions, seroma remains a major surgical complication.No method of prevention is completely satisfactory at the present time.Objective: we aim to present an experimental animal model of seroma production after latissimus dorsi muscle and axillary nodes harvest and follow-up protocol to evaluate the efficacy and tolerability of seroma prevention methods.Methods: we performed a harvest of the right latissimus dorsi muscle and axillary lymph nodes, in 50 Wistar rats divided in 5 groups (n = 10 rats per group). In group I no seroma prevention was performed. Seroma prevention groups were the following: in group II Quilting Sutures (QS), group III Fibrin Glue (FG) application, group IV VENASEAL ® application and group V NEXPOWDER ® application. Follow-up included standard photographs, in vivo fluorescence imaging of flap perfusion, microCT-scan, seroma puncture and histological flap analysis at POD7, 30 and 90.Results: we developed a reliable surgical animal model of latissimus dorsi harvest to create seroma as observed in clinical practice. At POD7 the use of QS, FG and VENASEAL ® showed a significant decrease in seroma volume compared with control group (respectively p=0.0016, p=0.0005 and p<0.0001) in both microCT-scan and puncture measurements. At POD30 there was no difference between groups. POD7 flap vascularization was significantly lower in control group compared to QS (p<0.0001), FG (p< 0.0001), VENASEAL ® (p<0.0001) and non-operated (p=0.0289) groups as illustrated by fluorescence imaging. Histological analysis showed significant inflammation in the prevention methods and specifically when a TA was used. Conclusion:Our animal model and monitoring methodology allow for assessing methods of prevention of seroma as well as the potential associated complications. It may be used as a basic protocol for further studies of innovative tissue adhesives.

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“…Thus, in this study, we comprehensively investigated the benefits and drawbacks of NP-based tissue glues in clinically relevant seroma scenarios. The seroma model is based on various rat models for seroma formation ( Harada et al, 1992 ; Kulber et al, 1997 ; Chung et al, 2006 ; Choi et al, 2012 ; Hurwitz et al, 2015 ; Lese et al, 2021 ). Based on the Kulber et al animal model, and on the model used in our previous short-term study, we opted for the same bilateral seroma rat model, where we successfully demonstrated surgically induced seroma formation ( Kulber et al, 1997 ; Lese et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Bioglass/ceria nanoparticle hybrids for the treatment of seroma: a comparative long-term study in rats

Pais,

Papanikolaou,

Hoyos

et al. 2024

Front. Bioeng. Biotechnol.

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Background: Seroma formation is a common postoperative complication. Fibrin-based glues are typically employed in an attempt to seal the cavity. Recently, the first nanoparticle (NP)-based treatment approaches have emerged. Nanoparticle dispersions can be used as tissue glues, capitalizing on a phenomenon known as ‘nanobridging’. In this process, macromolecules such as proteins physically adsorb onto the NP surface, leading to macroscopic adhesion. Although significant early seroma reduction has been shown, little is known about long-term efficacy of NPs. The aim of this study was to assess the long-term effects of NPs in reducing seroma formation, and to understand their underlying mechanism.Methods: Seroma was surgically induced bilaterally in 20 Lewis rats. On postoperative day (POD) 7, seromas were aspirated on both sides. In 10 rats, one side was treated with NPs, while the contralateral side received only NP carrier solution. In the other 10 rats, one side was treated with fibrin glue, while the other was left untreated. Seroma fluid, blood and tissue samples were obtained at defined time points. Biochemical, histopathological and immunohistochemical assessments were made.Results: NP-treated sides showed no macroscopically visible seroma formation after application on POD 7, in stark contrast to the fibrin-treated sides, where 60% of the rats had seromas on POD 14, and 50% on POD 21. At the endpoint (POD 42), sides treated with nanoparticles (NPs) exhibited significant macroscopic differences compared to other groups, including the absence of a cavity, and increased fibrous adhesions. Histologically, there were more macrophage groupings and collagen type 1 (COL1) deposits in the superficial capsule on NP-treated sides.Conclusion: NPs not only significantly reduced early manifestations of seroma and demonstrated an anti-inflammatory response, but they also led to increased adhesion formation over the long term, suggesting a decreased risk of seroma recurrence. These findings highlight both the adhesive properties of NPs and their potential for clinical therapy.

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Seroma Formation in Rat Latissimus Dorsi Resection in the Presence of Biologics

Cited by 6 publications

References 25 publications

Mixed Metal Oxide Nanoparticle Formulations for the Treatment of Seroma

Mixed Metal Oxide Nanoparticle Formulations for the Treatment of Seroma

Development of Experimental Animal Model and Methodology for Evaluation of a Seroma Prevention Approach

Bioglass/ceria nanoparticle hybrids for the treatment of seroma: a comparative long-term study in rats

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