Department of Breast Surgery F, University of Copenhagen, Herlev Hospital, Herlev, Denmark.
Department of Clinical Microbiology, University of Copenhagen, Herlev Hospital, Herlev, Denmark.
World J Surg Oncol. 2019 Jul 10;17(1):120. doi: 10.1186/s12957-019-1661-1.
Seroma formation is a frequent postoperative sequela after mastectomy for primary breast cancer. We investigated the role of bacterial colonization of seroma fluid with three different culture methods and the effect of intracavitary steroids.
The study group consisted of 212 patients scheduled for mastectomy from a previously performed double-blind randomized placebo-controlled intervention trial. The patients were allocated to a single dose of 80 mg of steroids (methylprednisolone) or saline, and the effect on seroma formation was investigated. From each aspiration, an equal volume of seroma fluid (10 mL) was distributed into one sterile transport tube (conventional method), one aerobic blood culture bottle and one anaerobic blood culture bottle.
There was significant variation in the number of bacterial species detected in seroma samples among the three culture methods, ranging from 18 species with the conventional culture tubes to 40 species with aerobic blood culture bottles. Patients receiving prophylactic steroids had significantly more frequent colonization than those in the saline group. Nevertheless, the clinical surgical site infection rate of 7.0% was equal between the two groups.
In general, data analysis of the entire set of case material did not succeed in demonstrating a relationship between a specific bacterial species or a combination of species and seroma formation. However, in the few patients with growth of a pathogenic species, both the duration of seroma formation and volume of seroma fluid were more pronounced.
Ethics Committee of Copenhagen (H-4-2009-137), (EudraCT number 2009-016650-40), the Danish Data Protection Agency (code J. no. F.750.75-2), and the Danish Health and Medicines Authority (sponsor protocol code number 23837). Start date November 2010.
血清肿形成是原发性乳腺癌乳房切除术后常见的术后后遗症。我们通过三种不同的培养方法研究了血清肿液细菌定植的作用以及腔内类固醇的作用。
研究组包括 212 名来自先前进行的双盲随机安慰剂对照干预试验的拟行乳房切除术的患者。将患者分为单剂量 80mg 类固醇（甲泼尼龙）或生理盐水组，并对其对血清肿形成的影响进行了研究。从每次抽吸中，等量的血清肿液（10ml）分别分配到一个无菌运输管（常规方法）、一个需氧血培养瓶和一个厌氧血培养瓶中。
三种培养方法检测到的血清肿样本中的细菌种类数量存在显著差异，从常规培养管的 18 种到需氧血培养瓶的 40 种。预防性使用类固醇的患者比生理盐水组的定植更为频繁。然而，两组的临床手术部位感染率均为 7.0%。
一般来说，对整个病例材料的数据分析未能证明特定细菌种类或物种组合与血清肿形成之间存在关系。然而，在少数有致病性物种生长的患者中，血清肿形成的持续时间和血清肿液的体积更为明显。
哥本哈根伦理委员会（H-4-2009-137），（EudraCT 编号 2009-016650-40），丹麦数据保护局（代码 J. no. F.750.75-2）和丹麦卫生和药品管理局（发起人协议编号 23837）。开始日期 2010 年 11 月。
