Efficacy of Fibrin Glue on Seroma Formation after Breast Surgery

Abstract

Background and Objectives. This study was designed to determine the effectiveness of fibrin glue plus conventional drain placement versus conventional drain placement in the prevention of seromas after breast procedures. Among methods employed to reduce seroma magnitude and duration, fibrin glue has been proposed in numerous studies, with controversial results. Design and Setting. A prospective, randomized, controlled study of subjects who were randomized into control and experimental groups was conducted. Methods. Collected data included age, surgeon, medical and surgical history, comorbidities, procedure performed, number of axillary nodes, number of positive axillary nodes collected, final pathologic diagnosis, cancer stage, hospital stay, postoperative day of drain removal, complications, incidence of seroma formation, interval to seroma resolution, and number of postoperative visits. Results. Analysis of 60 patients showed similarly matched groups. Seroma formation rate was 24.1% in the control group and 16.1% in the fibrin glue group. The rate of wound complications was similar. Conclusions. Although use of fibrin sealant resulted in a nonsignificant decrease in seroma formation rate compared with that of drain placement, the higher cost and cumbersome technique tend to indicate that there is no advantage to using fibrin glue over drain placement with the technique described.

Role of fibrin glue in seroma reduction after modified radical mastectomy

“…From these authors Ruggiero et al who mentioned that seroma magnitude and duration were significantly reduced and there were fewer evacuative punctures, in patients receiving fibrin glue compared with the conventional treatment group in his study over 90 patients. 26 Bonjar et al documented that the cumulative aspirate volumes for seromas in the drain group were significantly greater in control group than in the fibrin glue group. 27 Cumulative seroma volume in fibrin glue and control groups was 110 and 210 mL, respectively (P = 0.0015).…”

“…This result agrees with most publications. 6,13,[19][20][21][22][23][24][25][26]28,29 Accompanying with hospital stay time reduction there was also significant reduction in time passed to remove the drain. 6,13,21,24,25,29 Conflicting results were found by some authors telling that the effect of using the fibrin glue is doubtful or nonbeneficial.…”

Will a Fibrin Sealant be Effective as a Seroma Reductant and a Hemostatic Agent in Breast Reconstruction Using a Latissimus Dorsi Flap?

“…Considerable research has been conducted to determine whether FS affects seroma prevention. However, there is significant methodological and clinical diversity in these reports [7,14,15,24]. In some reports, both immediate and delayed breast reconstructions were included [15], and in certain reports, if the drains were retained even after 10 days of surgery, the patient was considered to have developed seroma [14].…”

“…However, there is significant methodological and clinical diversity in these reports [7,14,15,24]. In some reports, both immediate and delayed breast reconstructions were included [15], and in certain reports, if the drains were retained even after 10 days of surgery, the patient was considered to have developed seroma [14]. Further, on the basis of a review of 19 large randomized controlled trials involving seroma, Sajid et al [24] claimed that fibrin glue does not affect postoperative seroma.…”

“…In contrast, a number of reports have been published on the use of FS for donor-site seroma prevention in cases of LD flap surgery. Previous reports have stated that a single application of FS was not effective in the reduction of seroma and is thus not recommended [12][13][14]. One study has also reported that FS was effective in the reduction of seroma [15].…”