Kocdor M A, Kilic Yildiz D, Kocdor H, Canda T, Yilmaz O, Oktay G, Harmancioglu O
Department of Surgery, Dokuz Eylul University, Izmir, Turkey.
Eur Surg Res. 2008;40(3):256-62. doi: 10.1159/000112732. Epub 2007 Dec 20.
Seroma formation is the most common complication following mastectomy and axillary dissection (AD). Currently available interventions have aimed at obliterating dead space by inducing fibrosis and through various mechanical methods. Here, 5-fluorouracil (5-FU), used as a sclerosing agent for the prevention of seroma formation, was investigated in a rat mastectomy model.
20 rats were divided into two groups (5-FU and control). All rats underwent mastectomy and AD. Immediately following the operation, equal volumes of saline and 5-FU were administered under the surgical flaps. One week after the operation, seroma formation and wound-healing processes were evaluated using histopathological and biochemical investigations.
5-FU did not act as a sclerosing agent, yet it was highly effective in preventing seroma formation. The intensity of acute inflammation, vascularity, as well as leukocyte and fibroblast infiltration, were significantly lower in the 5-FU group than the control; the tissue collagen fractions and total seroma collagen contents were found to be similar between the two groups.
The mechanisms underlying seroma prevention by 5-FU are probably related to a decrease in the inflammation and angiogenesis rather than a local fibrotic process. Seroma formation may be due to a prolonged inflammatory phase of wound healing.
血清肿形成是乳房切除术和腋窝淋巴结清扫术（AD）后最常见的并发症。目前可用的干预措施旨在通过诱导纤维化和各种机械方法消除死腔。在此，在大鼠乳房切除模型中研究了用作预防血清肿形成硬化剂的5-氟尿嘧啶（5-FU）。
将20只大鼠分为两组（5-FU组和对照组）。所有大鼠均接受乳房切除术和腋窝淋巴结清扫术。手术后立即在手术皮瓣下注射等量的生理盐水和5-FU。术后1周，使用组织病理学和生化检查评估血清肿形成和伤口愈合过程。
5-FU不作为硬化剂，但在预防血清肿形成方面非常有效。5-FU组的急性炎症强度、血管生成以及白细胞和成纤维细胞浸润均明显低于对照组；两组的组织胶原蛋白分数和血清肿总胶原蛋白含量相似。
5-FU预防血清肿的机制可能与炎症和血管生成减少有关，而不是局部纤维化过程。血清肿形成可能是由于伤口愈合的炎症期延长所致。
