Department of Plastic and Reconstructive Surgery, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK.
Br J Surg. 2011 Jul;98(7):918-24. doi: 10.1002/bjs.7462. Epub 2011 Apr 1.
Excessive postoperative drainage following groin and axillary lymphadenectomy may be associated with a prolonged hospital stay and an increased complication rate. The use of fibrin sealant before wound closure may reduce postoperative wound drainage.
Consecutive patients undergoing elective groin or axillary lymphadenectomy were randomized to standard wound closure or to having fibrin sealant sprayed on to the wound bed before closure. Postoperative wound drainage, duration of drainage and complications were recorded, as were locoregional recurrence, distant metastasis and mortality.
A total of 74 patients requiring 38 groin and 36 axillary dissections were randomized. The median postoperative wound drainage volume for the groin dissection cohort was 762 (range 25-3255) ml in the control group and 892 (265-2895) ml in the treatment group (P = 0·704). Drainage volumes in the axillary cohort were 590 (230-9605) and 565 (30-1835) ml in the control and treatment groups respectively (P = 0·217). There was no difference in the duration of drainage or postoperative complication rate between the treatment groups in both the axillary and groin cohorts. Local recurrence, distant metastasis and mortality rates did not differ between the treatment groups.
There was no advantage in using fibrin sealant during elective lymphadenectomy in terms of reducing drainage output or postoperative complication rate.
腹股沟和腋窝淋巴结清扫术后过多的引流可能与延长住院时间和增加并发症发生率有关。在关闭伤口前使用纤维蛋白密封剂可能会减少术后伤口引流。
连续选择行择期腹股沟或腋窝淋巴结清扫术的患者，随机分为标准伤口关闭组或在关闭前将纤维蛋白密封剂喷洒到伤口床上。记录术后伤口引流、引流持续时间和并发症，以及局部区域复发、远处转移和死亡率。
共有 74 名需要 38 例腹股沟和 36 例腋窝清扫术的患者被随机分组。对照组腹股沟清扫术队列的术后伤口引流量中位数为 762（范围 25-3255）ml，治疗组为 892（265-2895）ml（P=0·704）。对照组和治疗组腋窝清扫术队列的引流体积分别为 590（230-9605）和 565（30-1835）ml（P=0·217）。两组在腋窝和腹股沟队列中，引流时间或术后并发症发生率均无差异。两组治疗组的局部复发、远处转移和死亡率无差异。
在选择性淋巴结清扫术中使用纤维蛋白密封剂在减少引流量或术后并发症发生率方面没有优势。
