富血小板血浆减少乳腺癌根治术和腋窝清扫术后血清肿形成风险的效果。

The Effects of Platelet-Rich Plasma to Decrease the Risk of Seroma Formation After Mastectomy and Axillary Dissection.

机构信息

Faculty of Medicine, Department of Surgery, Selcuk University, Konya, Turkey.

出版信息

J Surg Res. 2020 Dec;256:156-162. doi: 10.1016/j.jss.2020.06.037. Epub 2020 Jul 21.

DOI:10.1016/j.jss.2020.06.037

PMID:32707398

Abstract

BACKGROUND

Seroma, which is the most common complication after mastectomy and axillary dissection, is the leakage of the lymphovascular fluid into the dead space. It can cause local complications varying from delayed wound healing to infection and skin flap necrosis. The aim of this study was to evaluate whether platelet-rich plasma (PRP) reduces the risk of seroma formation.

MATERIALS AND METHODS

A total of 24 Wistar albino rats were randomly divided into three groups of eight rats in each. For the rats in group 1, no additional procedures were carried out. The rats in groups 2 and 3 were applied with 0.25 and 0.5 mL/cm PRP, respectively, to the operation site. The groups were compared in respect of adhesion scores, histopathologic examination, and tissue seroma volume.

RESULTS

The mean seroma volume was 2.19 ± 0.78 mL in group 1, 1.43 ± 0.35 mL in group 2, and 0.96 ± 0.24 mL in group 3. The seroma volumes of groups 3 and 2 were significantly lower than those in group 1. In the macroscopic assessment the mean general adhesion score was 6 ± 0.75 in group 3. The other general adhesion scores were 5.25 ± 0.70 and 2.12 ± 0.64 in groups 2 and 1, respectively. The adhesion scores of groups 3 and 2 were significantly higher than those of group 1. The mean inflammatory cell score was 0.87 ± 0.83 in group 3, 2.0 ± 0.92 in group 2, and 3.0 ± 0.53 in group 1. There were significantly lower levels of inflammatory cells in group 3 than in the other groups and the group 2 inflammatory cell count was lower than that of group 1. Fibroblast density score was significantly higher in group 3 (2.50 ± 1.06) compared with the other groups. Neovascularization was significantly higher in groups 3 and 2 compared with group 1. The mean neovascularization score was 2.25 ± 1.16 and 2.12 ± 1.12 in groups 2 and 3, respectively. There were no statistically significant differences between the groups in respect of collagen levels.

CONCLUSIONS

Local application of PRP in rats after experimental mastectomy and axillary dissection was observed to decrease seroma formation and to increase neovascularization and fibroblast density.

摘要

背景

血清肿是乳房切除术和腋窝清扫术后最常见的并发症，是淋巴血管液漏入死腔。它会导致局部并发症，从延迟伤口愈合到感染和皮瓣坏死不等。本研究的目的是评估富血小板血浆 (PRP) 是否降低血清肿形成的风险。

材料和方法

总共 24 只 Wistar 白化大鼠被随机分为三组，每组 8 只大鼠。对于第 1 组大鼠，不进行任何其他操作。第 2 组和第 3 组大鼠的手术部位分别应用 0.25 和 0.5 mL/cm 的 PRP。对各组的粘连评分、组织病理学检查和组织血清肿体积进行比较。

结果

第 1 组的平均血清肿体积为 2.19 ± 0.78 mL，第 2 组为 1.43 ± 0.35 mL，第 3 组为 0.96 ± 0.24 mL。第 3 组和第 2 组的血清肿体积明显低于第 1 组。在宏观评估中，第 3 组的平均总粘连评分 6 ± 0.75。其他总粘连评分分别为第 2 组和第 1 组的 5.25 ± 0.70 和 2.12 ± 0.64。第 3 组和第 2 组的粘连评分明显高于第 1 组。第 3 组的平均炎症细胞评分 0.87 ± 0.83，第 2 组为 2.0 ± 0.92，第 1 组为 3.0 ± 0.53。第 3 组的炎症细胞水平明显低于其他组，第 2 组的炎症细胞计数低于第 1 组。成纤维细胞密度评分在第 3 组（2.50 ± 1.06）明显高于其他组。第 3 组和第 2 组的新生血管化明显高于第 1 组。第 2 组和第 3 组的平均新生血管化评分分别为 2.25 ± 1.16 和 2.12 ± 1.12。各组间胶原水平无统计学差异。