Seroma Prevention by Using <i>Corynebacterium parvum</i> in a Rat Mastectomy Model

Abstract

Seroma formation is the most common complication after mastectomy and continues to be an important problem during the early postoperative period. Several surgical and medical methods have been developed to try to overcome this problem; however, so far none have been used successfully in the routine clinical practice. The aim of this study is to evaluate the effects of Corynebacterium parvum (CP) as a sclerosing agent in both prevention and treatment of seromas after mastectomy and axillary dissection in an animal model. Sixty female Sprague-Dawley rats underwent mastectomy and axillary dissection under general anaesthesia. Following surgery, the rats were treated in 1 of 3 ways. In the prevention group, 1 cm³ (0.35 mg) CP solution was injected beneath the skin flap just before closure of the incision after mastectomy. In the treatment group, animals in which a seroma was formed, the fluid was aspirated, and 1 cm³ CP solution was injected beneath the flap. In the control group, animals in which seromas formed, aspiration only was performed. The frequency of seroma formation decreased when CP solution was injected immediately after the operation (p < 0.01). In addition, seroma formation was effectively treated by CP injection when compared with the control group (p < 0.05). CP was effective as a prophylactic agent in the prevention group and as a therapeutic agent in the treatment group in this experimental model. CP injection may be useful for the management of this problem in a clinical setting.

Microporous Polysaccharide Hemospheres and Seroma Formation After Mastectomy and Axillary Dissection in Rats

“…In other words, it can be defined as inability of the wound edges to join together. To achieve this closure, bovine thrombin, fibrin glue, talc, tranexamic acid, Corynebacterium parvum, tetracycline and several antineoplastic agents have been used, but all these approaches have failed to provide a significant effect (7,9). In 1913, Halsted described fixation of the skin flaps to the chest wall using sutures and found that this approach reduced seroma formation (22).…”

“…However, seromas can lead to a number of serious complications including wound infection, lymphedema, flap necrosis, prolonged length of hospital stay, sepsis, as well as delay in initiation of adjuvant therapy. Several methods have been proposed to prevent seroma formation, but none of these methods provided a significant effect (1,6,7). Therefore seroma is still a serious problem and new methods are required in order to prevent it.…”

“…The pathophysiological changes underlying seroma formation remain unclear (7,8). It has traditionally been assumed that drainage of lymph from divided mammary and axillary lymphatics secondary to mastectomy is responsible for seroma formation (1,8,9).…”

Design of an injectable synthetic and biodegradable surgical biomaterial

“…Surgical techniques, such as collapsing the seroma cavity with sutures, do not consistently and adequately eliminate seroma formation (16,18,19). Other methods, such as sclerotherapy (20,21), compression dressings (22), and biological adhesives, particularly fibrin glue (23)(24)(25)(26)(27), have not significantly decreased the clinical incidence of seroma formation.…”

Systemic toxicity of non-cell corynebacterium parvum (CP) in monkeys

“…In the past 40 years, CP has been widely studied with respect to its therapeutic effect and action mechanism, including inhibition of tumor growth, resistance against various infections and so on (Dye et al, 1981;Raiford et al, 1994;Tekin et al, 2001).Among these therapeutic effects, the anti-tumor effect has received much attention, and has been examined both in vitro and in vivo (Koukalová et al, 1992;Purnell et al, 1979;El Kappany et al, 1980;Collins et al, 1977).…”