Fibrin sealant decreases postoperative drainage in immediate breast reconstruction by deep inferior epigastric perforator flap after mastectomy with axillary dissection

Hivelin, Mikaël; Heusse, J. L.; Matar, Nadia; Lepage, C.; Lantieri, Laurent

doi:10.1002/micr.20812

Cited by 14 publications

(6 citation statements)

References 41 publications

(39 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…One study was excluded from the analysis due to its retrospective nature [ 13 ]. At the end of the selection process, 23/223 (10.3%) screened studies met the inclusion criteria [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. Figure 1 shows the PRISMA flow chart outlining the process of evidence acquisition.…”

Section: Resultsmentioning

confidence: 99%

Fibrin Sealants and Axillary Lymphatic Morbidity: A Systematic Review and Meta-Analysis of 23 Clinical Randomized Trials

Gasparri

Kuehn

Ruscito

et al. 2021

Cancers

View full text Add to dashboard Cite

Background: use of fibrin sealants following pelvic, paraaortic, and inguinal lymphadenectomy may reduce lymphatic morbidity. The aim of this meta-analysis is to evaluate if this finding applies to the axillary lymphadenectomy. Methods: randomized trials evaluating the efficacy of fibrin sealants in reducing axillary lymphatic complications were included. Lymphocele, drainage output, surgical-site complications, and hospital stay were considered as outcomes. Results: twenty-three randomized studies, including patients undergoing axillary lymphadenectomy for breast cancer, melanoma, and Hodgkin’s disease, were included. Fibrin sealants did not affect axillary lymphocele incidence nor the surgical site complications. Drainage output, days with drainage, and hospital stay were reduced when fibrin sealants were applied (p < 0.0001, p < 0.005, p = 0.008). Conclusion: fibrin sealants after axillary dissection reduce the total axillary drainage output, the duration of drainage, and the hospital stay. No effects on the incidence of postoperative lymphocele and surgical site complications rate are found.

show abstract

Section: Resultsmentioning

confidence: 99%

Fibrin Sealants and Axillary Lymphatic Morbidity: A Systematic Review and Meta-Analysis of 23 Clinical Randomized Trials

Gasparri

Kuehn

Ruscito

et al. 2021

Cancers

View full text Add to dashboard Cite

show abstract

“…18 Similarly, Ali et al and Hivelin et al found that fibrin glue led to a significant reduction in the duration of drainage and earlier drain removal following reconstruction. 19,20 Dancey et al and Fang et al found a significant reduction in both drainage duration and seroma formation with fibrin glue and proposed that the additional cost of fibrin glue was worthwhile with regard to improved postoperative outcomes. 21,22 Bailey et al likewise showed a significant reduction in drainage duration, but the effect of fibrin glue on rate of seroma formation was not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

Fibrin Sealants Do Not Reduce the Rate of Seroma Formation in Postmastectomy Breast Reconstruction: A Systematic Review and Meta-analysis

Massada

Webster

et al. 2022

J Reconstr Microsurg Open

View full text Add to dashboard Cite

Background Breast reconstruction using deep inferior epigastric perforator (DIEP) and latissimus dorsi (LD) flaps following mastectomy are associated with seroma formation, most commonly at the donor site. We sought to perform an updated systematic review and meta-analysis on the effects of fibrin sealant on donor-site complications following DIEP and LD flap breast reconstruction. Methods A comprehensive literature search was conducted (March 2021) in PubMed, OVID, and Cochrane databases. Articles analyzing the efficacy of fibrin glue in reducing donor-site morbidity in DIEP and LD breast reconstruction were included. The outcomes assessed were seroma formation and duration of drainage. Results A total of 17,265 articles were screened, and 9 articles were selected for analysis, which comprised 632 surgical sites in 611 patients. Comparing fibrin glue and quilting to quilting alone showed no significant difference in seroma formation (pooled risk ratio [RR]: 0.51; 95% confidence interval [CI]: 0.12, 2.25). Similarly, comparing fibrin glue alone to no fibrin glue showed no significant difference in seroma formation (pooled RR: 1.03; 95% CI: 0.66, 1.61) or duration of drain (pooled RR: −0.85; 95% CI: −4.09, 2.40); there was however a difference in duration of drain in those who received fibrin glue and quilting versus quilting alone (pooled RR: −2.13; 95% CI: −3.27, −0.99). Conclusion The existing literature supports that the use of fibrin glue is not associated with a decrease in seroma formation in DIEP and LD flaps and is weakly associated with a reduction in the drainage duration only if used in conjunction with quilting.

show abstract

“…Benevento et al reported that fibrin sealants were able to reduce the output of serum from the axilla in patients who underwent axillary lymphadenectomy for breast cancer [ 9 ]. Fibrin sealants help to augment the final stage of coagulation when fibrinogen is converted into stable fibrinogen clot [ 18 ]. Fibrin formation not only controls bleeding, but also creates an adhesive barrier.…”

Section: Discussionmentioning

confidence: 99%

“…Fibrin formation not only controls bleeding, but also creates an adhesive barrier. It could be expected that the fibrin sealant's hemostatic and adhesive properties could help reduce lymphatic drainage by sealing damaged lymphatic vessels via a less traumatic mechanism [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Fibrin Sealant Patch in Reducing Drain Volume after Pelvic Lymph Node Dissection in Women with Gynecologic Malignancy

Kim

Choi

Kim

2017

BioMed Research International

View full text Add to dashboard Cite

Background The goal of this study was to evaluate the effectiveness of fibrin sealant in decreasing postoperative lymphatic drainage in women after pelvic lymphadenectomy and/or para-aortic lymphadenectomy during gynecologic cancer surgery. Methods This study is a retrospective case-control study. Forty-five patients who underwent staging surgery were enrolled. Twenty-seven patients were in the fibrin sealant group (group A) and 18 in the control group (group B). The two groups were compared for the total volume of drain, hospital stay, harvested lymph node, and incidence of asymptomatic lymphocele. Lymphocele formation was evaluated by computed tomography (CT) on 3 months after surgery. Results There were no significant differences in patient demographics between group A and B with respect to age, BMI, and harvested lymph nodes. Patients who received fibrin sealants had reduced total volume of drainage from postoperative days 2 to 5 compared to the control group (group A versus group B: 994.819 ± 745.85 ml versus 1847.89 ± 1241.41 ml; P = 0.015). However no differences were observed in hospital stay (P = 0.282), duration of drain (P = 0.207), and incidence of asymptomatic lymphocele at 3 months (P = 0.126). Conclusion The results of this study indicate that the application of fibrin sealants after pelvic and/or para-aortic lymphadenectomy may reduce lymphatic drainage in gynecologic malignancy.

show abstract

Fibrin sealant decreases postoperative drainage in immediate breast reconstruction by deep inferior epigastric perforator flap after mastectomy with axillary dissection

Abstract: This study introduce the interest of fibrin sealant to significantly decrease the postoperative drainage volume and duration in the thoracic area after immediate breast reconstruction by DIEP flap.

Cited by 14 publications

References 41 publications

Fibrin Sealants and Axillary Lymphatic Morbidity: A Systematic Review and Meta-Analysis of 23 Clinical Randomized Trials

Fibrin Sealants and Axillary Lymphatic Morbidity: A Systematic Review and Meta-Analysis of 23 Clinical Randomized Trials

Fibrin Sealants Do Not Reduce the Rate of Seroma Formation in Postmastectomy Breast Reconstruction: A Systematic Review and Meta-analysis

Effectiveness of Fibrin Sealant Patch in Reducing Drain Volume after Pelvic Lymph Node Dissection in Women with Gynecologic Malignancy

Contact Info

Product

Resources

About