Zhu Wenzhen, Yang Jian, Iqbal Jabed, Peck Yvonne, Fan Changjiang, Wang Dong-An
Division of Bioengineering, School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore, Singapore.
Orthopaedics Department, The Fifth Affiliated Hospital, Chongqing Medical University, Chongqing, China.
J Surg Res. 2017 Jul;215:173-182. doi: 10.1016/j.jss.2017.03.020. Epub 2017 Mar 31.
Seroma formation is a common postsurgical complication of breast cancer surgery. It delays wound healing and may lead to other more serious complications. Conventional methods of reducing seroma formation through suturing or placement of surgical drainage produce inconsistent clinical outcomes. Tissue adhesives are viable alternatives but most of them are unsuitable for internal use and for large-area applications because of weak tissue adhesion strength or biocompatibility issues. The aim of this study was to evaluate the efficacy and biocompatibility of a mussel-inspired double-crosslinked tissue adhesive (DCTA) in reducing seroma formation after mastectomy.
Thirty-six female Sprague-Dawley rats were randomly assigned to either the saline control group (n = 12), the TISSEEL sealant (Baxter) group (n = 12), or the DCTA group (n = 12). After performing a mastectomy and applying the corresponding treatment, the efficacy of DCTA was evaluated by measurement of seroma volume while its biocompatibility was assessed via micronuclei test and histopathologic examination.
During the 1-wk postsurgical period, the average total seroma volume of DCTA was significantly lower than the saline control group. Importantly, the mean seroma volume in DCTA showed a decreasing trend, whereas those in TISSEEL and saline control groups showed otherwise. The application of DCTA showed no genotoxic effect on the host and no severe inflammation.
This study demonstrates that the good tissue adhesion strength and stability of DCTA were successful in reducing seroma formation over a period of 1 wk. Furthermore, the results also showed that it is biocompatible, which makes it suitable for large-area, internal use.
血清肿形成是乳腺癌手术常见的术后并发症。它会延迟伤口愈合，并可能导致其他更严重的并发症。通过缝合或放置手术引流管来减少血清肿形成的传统方法，其临床效果并不一致。组织粘合剂是可行的替代方法，但由于组织粘附强度弱或生物相容性问题，它们中的大多数不适合内部使用和大面积应用。本研究的目的是评估一种受贻贝启发的双交联组织粘合剂（DCTA）在减少乳房切除术后血清肿形成方面的疗效和生物相容性。
将36只雌性Sprague-Dawley大鼠随机分为生理盐水对照组（n = 12）、TISSEEL密封剂（百特公司）组（n = 12）或DCTA组（n = 12）。在进行乳房切除术后并应用相应治疗后，通过测量血清肿体积评估DCTA的疗效，同时通过微核试验和组织病理学检查评估其生物相容性。
在术后1周期间，DCTA组的平均血清肿总体积显著低于生理盐水对照组。重要的是，DCTA组的平均血清肿体积呈下降趋势，而TISSEEL组和生理盐水对照组则不然。DCTA的应用对宿主没有遗传毒性作用，也没有严重炎症。
本研究表明，DCTA良好的组织粘附强度和稳定性在1周内成功减少了血清肿的形成。此外，结果还表明它具有生物相容性，这使其适用于大面积的内部使用。
