Ulusoy Ali Naki, Polat Cafer, Alvur Muhlise, Kandemir Bedri, Bulut Feridun
Department of Surgery, Ondokuz Mayis University School of Medicine, Samsun, Turkey.
Breast J. 2003 Sep-Oct;9(5):393-6. doi: 10.1046/j.1524-4741.2003.09506.x.
Seroma formation is a frequently occurring complication in patients operated on because of breast cancer. This complication can be the cause of flap necrosis, can lead to infection, and can prolong the hospital stay. It can also cause a delay in chemotherapy and radiotherapy. In order to prevent seroma formation, various methods such as external compression dressings, immobilization of the arm, sclerotherapy, and suction drainage have been used, without much success. In animal models and some clinical studies, it has been stated that fibrin glue reduces seroma formation, and these statements generated high expectations. For this reason, a prospective study was planned to test this in patients who underwent modified radical mastectomy (MRM) because of breast cancer. Of the 54 patients studied, 27 patients had fibrin glue (4 ml) applied to wound surfaces and under the flap (study group); the remaining 27 patients were the control group. Daily drainage volumes, total amount of drainage, drain removal time, and seroma formation were recorded and compared between the two groups. The first-day drainage was significantly lower in the study group (p<0.05, Student's t-test). There were no significant differences in daily drainage volumes, drain removal time, seroma formation frequency, and the number of seromas between the two groups (p>0.05). In conclusion; fibrin glue application had no significant benefit on axillary lymphatic drainage, drain removal time, or seroma formation.
血清肿形成是乳腺癌手术患者中经常出现的一种并发症。这种并发症可能导致皮瓣坏死，引发感染，并延长住院时间。它还可能导致化疗和放疗延迟。为了预防血清肿形成，人们采用了各种方法，如外部压迫敷料、手臂固定、硬化疗法和负压引流，但效果不佳。在动物模型和一些临床研究中，有人指出纤维蛋白胶可减少血清肿形成，这些说法引发了很高的期望。因此，计划进行一项前瞻性研究，在因乳腺癌接受改良根治性乳房切除术（MRM）的患者中对此进行测试。在研究的54例患者中，27例患者在伤口表面和皮瓣下应用了纤维蛋白胶（4毫升）（研究组）；其余27例患者为对照组。记录并比较两组的每日引流量、总引流量、拔管时间和血清肿形成情况。研究组第一天的引流量明显较低（p<0.05，学生t检验）。两组在每日引流量、拔管时间、血清肿形成频率和血清肿数量方面无显著差异（p>0.05）。总之，应用纤维蛋白胶对腋窝淋巴引流、拔管时间或血清肿形成没有显著益处。
