Does Fibrin Glue Improve Drainage after Axillary Lymph Node Dissection? Prospective and Randomized Study in Humans

Vaxman, F; Kolbe, Anne; Stricher, F.; Zund, D.; Volkmar, Pierre-Philippe; Gros, Dominique; Grenier, J F

doi:10.1159/000129419

Cited by 55 publications

(33 citation statements)

References 14 publications

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“…Bovine thrombin has also proved unsuccessful in this regard. The employment of fibrin glue was encouraged after studies on animals [23,24], especially rats that underwent mastectomy, but in human studies no significant advantage was seen [25][26][27]. In a recent work, Johnson and Coll showed a lower rate of seroma formation using fibrin glue alone (36.8%) versus conventional drain placement (45%), but this difference was not significant.…”

Section: Discussionmentioning

confidence: 99%

Does LigaSure(TM) reduce fluid drainage in axillary dissection? A randomised prospective clinical trial

Antonio¹

2015

ecancer

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Background: Axillary lymph node dissection (ALND) is an integral part of breast cancer treatment. It is required in about 40-50% of patients. The placement of a drain in the axilla after an operation is current surgical practice. Short surgical stay programmes increase operating efficiency and reduce medical care costs, without compromising quality of care. LigaSure TM is a new haemostatic device that uses bipolar energy to seal vessels. The aim of this study is to determine whether axillary dissection with LigaSure TM reduces the time of wound drainage, the duration of surgical intervention and the volume of drainage after treatment.

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Section: Discussionmentioning

confidence: 99%

Does LigaSure(TM) reduce fluid drainage in axillary dissection? A randomised prospective clinical trial

Antonio¹

2015

ecancer

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“…Another approach can be to glue together the wound surfaces after dissection, and the introduction of fibrin glue 15 years ago suggested new possibilities [9]. Nevertheless, no advantage could be shown in the use of fibrin glue after lymphadenectomy [10,11]. Some studies reported a success in rat mastectomy models [12,13], but only two human reports [4,14] were able to reduce the incidence of seroma or daily drainage volume with fibrin glue after mastectomy.…”

Section: Discussionmentioning

confidence: 99%

Prevention of Lymphorrhea by Means of Fibrin Glue after Axillary Lymphadenectomy in Breast Cancer: Prospective Randomized Trial

François

et al. 1998

Eur Surg Res

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A prospective randomized trial was carried out to evaluate the efficacy of fibrin glue in preventing lymphorrhea after axillary lymphadenectomy in breast cancer. One hundred and eight breast cancer patients, operated on by two senior surgeons, were randomized into two groups: group 1 (n = 58) without fibrin glue and group 2 (n = 50) with 2 ml of fibrin glue applied to the axillary dissection area at the end of the lymphadenectomy procedure. Early postoperative morbidity was 2/58 and 0/50 in groups 1 and 2, respectively. Mean daily postoperative drainage was significantly greater in group 1. The mean cumulative drainage quantity 6 days after the operation was 407.8 ml and 214.4 ml in groups 1 and 2, respectively (p = 0.001). The mean postoperative hospital stay was 10.1 days and 8.0 days in groups 1 and 2, respectively (p = 0.006). One delayed seroma was observed in each group. Fibrin glue seems to reduce daily postoperative drainage and hospital stay, but did not affect delayed seroma formation after axillary lymphadenectomy for breast cancer.

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“…18, 30 Vaxman et al reported that with the use the fibrin glue the total drain output increased. 31 Moreover, Dinsmore et al stated that not only the drainage volume increased but also the overall complication rate increased. 32 Dinsmore et al in spite of his criticism to fibrin glue usage, he put a hypothesis suggesting that the lack of benefit was due to the presence of drains that may interfere with the stabilization of a fibrin clot and with closure of the lymphatic capillaries.…”

Section: The Statistical Analysis Of Received Pre-and Postoperative Dmentioning

confidence: 99%

Role of fibrin glue in seroma reduction after modified radical mastectomy

Fawzy¹,

Gaber²,

Farid³

2017

Int Surg J

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INTRODUCTIONBreast cancer is the second leading cause of cancer death among women. The surgical treatment is the best choice for those patients. 1 Since the first mastectomy which was carried out by Halsted in 1882, surgeons have faced several problems such as skin flaps necrosis, wound breakdown, seroma, infection, nerve injuries, lymphedema, phantom breast syndrome and hematoma. Seroma, which is a subcutaneous collection of serous fluid, is a common problem in breast surgery where it develops under the skin flaps during mastectomy or in the axillary dead space after axillary dissection. It usually resolves within a few weeks, so many surgeons view this problem as an unavoidable nuisance rather than a serious complication. 3Seroma formation is the most frequent postoperative complication after breast cancer surgery. Incidence of seroma formation after breast surgery varies between 2.5% and 51%. Although seroma is not life threatening, it can lead to significant morbidity (e.g. flap necrosis, wound dehiscence, predisposes to sepsis, prolonged recovery period, multiple physician visits) and it may delay adjuvant therapy.1 The pathogenesis of seroma has not been fully elucidated. It has been hypothesized that seromas form as an exudate from an acute inflammatory ABSTRACT Background: Seroma is one of the most common morbidity occurring post modified radical mastectomy (MRM). It can delay post-operative initiation of adjuvant therapy. This study was designed to determine the role of fibrin glue spray in reduction of seroma volume and duration after breast surgeries. Methods: A prospective, randomized, controlled study over forty female patients who underwent (MRM) was done. The study cohort was randomized into control group where only conventional drain placement was used and experimental group where double dose of fibrin glue has been sprayed to the axillary and mammary beds plus conventional drain placement. Data regarding the amount of drained fluid in the first post-operative day, hospital stay, length of drain placement, amount and duration of post-operative seroma, number of excised lymph nodes (L. Ns) and pathological results were recorded. Results: No difference in mean age, number of excised L. Ns and rate of post-operative infection between both groups was detected. There was significant reduction in hospital stay time favouring fibrin glue group (p=0.006). Fibrin glue group had a significant reduction in the length of drain placement (p=0.001). The amount of postoperative serous fluid was reduced and the incidence of occurrence of post-operative seroma was (7/20) 35% in control group compared to (1/20) 5% in fibrin glue group giving significant reduction in incidence and amount. Conclusions: Use of fibrin glue sealant during MRM resulted in noticeable and significant decrease of post-operative rate of seroma formation, its amount and the length of drain placement.

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Does Fibrin Glue Improve Drainage after Axillary Lymph Node Dissection? Prospective and Randomized Study in Humans

Cited by 55 publications

References 14 publications

Does LigaSure(TM) reduce fluid drainage in axillary dissection? A randomised prospective clinical trial

Does LigaSure(TM) reduce fluid drainage in axillary dissection? A randomised prospective clinical trial

Prevention of Lymphorrhea by Means of Fibrin Glue after Axillary Lymphadenectomy in Breast Cancer: Prospective Randomized Trial

Role of fibrin glue in seroma reduction after modified radical mastectomy

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