Rice D C, Morris S M, Sarr M G, Farnell M B, van Heerden J A, Grant C S, Rowland C M, Ilstrup D M, Donohue J H
Department of Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
J Surg Oncol. 2000 Apr;73(4):224-7. doi: 10.1002/(sici)1096-9098(200004)73:4<224::aid-jso7>3.0.co;2-0.
Postoperative wound seromas are a frequent and troublesome occurrence after mastectomy. Recent reports have suggested the efficacy of topical sclerosants at reducing their formation.
A prospective, randomized, double-blinded trial was performed to examine the effect of intraoperatively administered topical tetracycline on the occurrence of postoperative mastectomy seromas. Thirty-two women were randomized to the control arm (normal saline) and 30 women to the tetracycline arm. In the treatment group, 100 ml (2 g) of tetracycline solution was administered topically to the chest wall and skin flaps prior to skin closure. The control group received an equal volume of normal saline. Patients were monitored for the development of postoperative wound seroma.
There were no significant differences between groups regarding total volume of closed suction drainage, numbers of patients leaving hospital with drains in place, or duration of catheter drainage. Seroma formation 2 weeks postoperatively was greater in the tetracycline group than the control group (53% vs. 22%, P = 0.01). There were no differences between groups regarding the degree of postoperative pain, wound infection, or seroma formation 1 month postoperatively.
Topical tetracycline is not effective at preventing post-mastectomy wound seromas.
乳房切除术后伤口血清肿是一种常见且麻烦的情况。近期报告显示局部硬化剂在减少其形成方面具有疗效。
进行了一项前瞻性、随机、双盲试验，以研究术中局部应用四环素对乳房切除术后血清肿发生情况的影响。32名女性被随机分配至对照组（生理盐水），30名女性被分配至四环素组。在治疗组中，在皮肤缝合前将100毫升（2克）四环素溶液局部应用于胸壁和皮瓣。对照组接受等量的生理盐水。对患者进行术后伤口血清肿发生情况的监测。
在闭式负压引流总量、带引流管出院的患者数量或导管引流持续时间方面，两组之间无显著差异。术后2周时，四环素组的血清肿形成情况比对照组更严重（53%对22%，P = 0.01）。在术后疼痛程度、伤口感染或术后1个月时的血清肿形成情况方面，两组之间无差异。
局部应用四环素在预防乳房切除术后伤口血清肿方面无效。
