Lee Jung Ho, Ryu Jeong Yeop, Lee Joon Seok, Choi Kang Young, Chung Ho Yun, Cho Byung Chae, Lee Jeeyeon, Park Ho Yong, Yang Jung Dug
Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, 130 Dongdeok-ro, Jung-gu, Daegu, 41944, Korea.
Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.
Aesthetic Plast Surg. 2022 Dec;46(6):3063-3071. doi: 10.1007/s00266-022-03032-0. Epub 2022 Aug 19.
Seroma is the most common complication after mastectomy and reconstruction surgery. Therefore, this study aimed to determine whether the topical application of tranexamic acid would be useful to reduce seromas in a rat mastectomy model.
Forty-eight Sprague-Dawley rats were divided into four groups. After mastectomy and axillary lymph node dissection, 0.4 mL of normal saline was administered to group A in the dead space. In group B, 0.4 mL of a triamcinolone mixed solution was administered. In group C, 0.4 mL of a tranexamic acid (10 mg/kg) mixed solution was administered. In group D, 0.4 mL of a tranexamic acid (50 mg/kg) mixed solution was administered. Gross examination, assessment with micro-computed tomography (CT), quantitative analysis via aspiration, and histopathologic assessment were implemented 7 and 14 days postoperatively.
No other complications such as wound infection and skin necrosis were observed. At postoperative week 1, groups B and C showed significantly lower seroma volume values on micro-CT (P < 0.001 and P < 0.05, respectively) and seroma volume values at aspiration (P < 0.01 and P < 0.001, respectively) than group A. According to histopathologic analysis, inflammation was observed more frequently in groups A and D than in the other groups, and angiogenesis was more active in groups B and C than in the other groups.
Topical application of tranexamic acid was as effective as topical application of triamcinolone to prevent seroma formation. The stability of tranexamic acid was confirmed when the high dose of tranexamic acid was used.
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血清肿是乳房切除术和重建手术后最常见的并发症。因此，本研究旨在确定在大鼠乳房切除模型中局部应用氨甲环酸是否有助于减少血清肿。
将48只Sprague-Dawley大鼠分为四组。乳房切除和腋窝淋巴结清扫术后，A组在死腔中注入0.4 mL生理盐水。B组注入0.4 mL曲安奈德混合溶液。C组注入0.4 mL氨甲环酸（10 mg/kg）混合溶液。D组注入0.4 mL氨甲环酸（50 mg/kg）混合溶液。术后7天和14天进行大体检查、微计算机断层扫描（CT）评估、穿刺定量分析和组织病理学评估。
未观察到伤口感染和皮肤坏死等其他并发症。术后第1周，B组和C组微CT上的血清肿体积值（分别为P < 0.001和P < 0.05）以及穿刺时的血清肿体积值（分别为P < 0.01和P < 0.001）均显著低于A组。根据组织病理学分析，A组和D组比其他组更频繁地观察到炎症，B组和C组比其他组的血管生成更活跃。
局部应用氨甲环酸在预防血清肿形成方面与局部应用曲安奈德同样有效。使用高剂量氨甲环酸时，其稳定性得到证实。
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