Ahmed Furqan Mohammed, Shankar Gomathi, Jain Ankit, G Balasubramaniyan
Department of General Surgery, Jipmer, Puducherry, India.
Indian J Surg Oncol. 2025 Feb;16(1):190-197. doi: 10.1007/s13193-024-02050-5. Epub 2024 Aug 13.
Seroma and high drain output is common complication after modified radical mastectomy (MRM). MRM leaves behind a negative space which fills up with fluid from cut lymphatics and tissue leading to seroma. Tranexamic acid decreases clot degradation thereby plugging the vessels leading to decreased seroma. This study is to determine if tranexamic acid reduces the incidence of seroma formation, drain output, and wound-related complications in post-operative cases of MRM. We conducted a prospective, double blinded, parallel arm, randomized control trial of 160 women with breast cancer undergoing MRM to study the effect of tranexamic in reducing seroma and drain output. Patients were recruited from a period of 2021-2022. Tranexamic acid was given 15 mg/kg IV at the time of administration of anaesthesia and 500 mg twice a day for 5 days with the control group receiving a placebo. The cases were followed up for a period of one month. Drain output, clinical seroma formation, and wound-related complications were recorded. There was a significant reduction in the drain output compared to the patients receiving a placebo (590 ml vs 725 ml: = 0.001). The number of patients developing a clinically detectable seroma was also reduced (16.3% vs 31.3%: = 0.025). Tranexamic acid also led to reduction in wound infection (6.3% vs 23.8%: = 0.002). Wound dehiscence and flap necrosis was also lower in the tranexamic acid group, but it was not statistically significant. Our results show that tranexamic acid reduces seroma formation, facilitates early drain removal, and reduces the wound infection in patients undergoing MRM.
The online version contains supplementary material available at 10.1007/s13193-024-02050-5.
血清肿和高引流液量是改良根治性乳房切除术（MRM）后常见的并发症。MRM术后会留下一个腔隙，该腔隙会被切断的淋巴管和组织渗出的液体充满，从而导致血清肿。氨甲环酸可减少血凝块降解，从而堵塞血管，减少血清肿形成。本研究旨在确定氨甲环酸是否能降低MRM术后患者血清肿形成的发生率、引流液量及伤口相关并发症的发生率。我们对160例行MRM的乳腺癌女性患者进行了一项前瞻性、双盲、平行组、随机对照试验，以研究氨甲环酸对减少血清肿和引流液量的作用。患者于2021年至2022年期间招募。麻醉给药时静脉注射氨甲环酸15mg/kg，随后每天两次，每次500mg，共5天，对照组接受安慰剂。对病例进行了为期一个月的随访。记录引流液量、临床血清肿形成情况及伤口相关并发症。与接受安慰剂的患者相比，引流液量显著减少（590ml对725ml：P = 0.001）。发生临床可检测血清肿的患者数量也减少了（16.3%对31.3%：P = 0.025）。氨甲环酸还导致伤口感染减少（6.3%对23.8%：P = 0.002）。氨甲环酸组伤口裂开和皮瓣坏死的发生率也较低，但无统计学意义。我们的结果表明，氨甲环酸可减少MRM患者的血清肿形成，促进早期拔除引流管，并减少伤口感染。
在线版本包含可在10.1007/s13193-024-02050-5获取的补充材料。
