Sealants after axillary lymph node dissection for breast cancer: good intentions but bad results

The role of fibrin glue instillation under skin flaps in the prevention of seroma formation and related morbidities following breast and axillary surgery for breast cancer: A meta‐analysis

“…Use of mastectomy flap dissection tools, ultrasound scissors versus electrocautery versus scalpel dissection 63, 64 were evaluated with equivocal results. Other seroma reduction interventions after mastectomy and axillary dissection include postoperative shoulder immobilisation to prevent shearing forces at the wound site 65, use of tetracycline sclerotherapy 66 and or talc poulderage 67 underneath skin flaps, various sealants 68, ketoprofen therapy 69, coated collagen patches 70, bovine thrombin instillation 49 and FG or spray 71, 72. All reported techniques to reduce the incidence of postoperative seroma showed variable success rates but not a single approach could achieve popularity due to conflicting results of investigating randomised, controlled trials.…”

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

“…A recent study on sealant use45 concluded on the absence of efficacy and the induction of an important inflammation. The glues studied were not fibrin sealants but synthetic polyethylene glycol hydrogel (COSEAL®, Baxter, Maurepas, France) designed for an external use, or a bovine albumin and glutaraldehyde solution (BioGlue®, Cryolife Europa, Guildford, United Kingdom) designed for liver and vascular surgery.…”

State-of-the-Art Review: Hemostats, Sealants, and Adhesives II: Update As Well As How and When to Use the Components of the Surgical Toolbox

“…52 The use of 2 PEG polymer hydrogel or albumin and glutaraldehyde did not reduce seroma fluid drainage or time to drain removal following axillary dissection procedures for treatment of breast cancer in a randomized, prospective, controlled trial of 75 patients. 53 Use of these sealants resulted in foreign body tissue reaction with the need for surgical intervention in some patients. Another consecutive case study of using albumin and glutaraldehyde in breast cancer surgery found a statistically significant beneficial effect on the frequency and volume of aspirated seromas during the recovery period in 33 treated patients as compared to 32 control patients.…”