Abstract • Seromas are a frequent complication of mastectomy (17% to 53%) in humans and are correlated to skin flap elevation, lymphovascular interruption, and drainage into surgically created potential spaces. The use of intraoperative topical fibrin glue to reduce morbidity in rats undergoing radical mastectomies has been evaluated. A model consistently producing seromas was developed by radical mastectomy and lymphadenectomy in the Sprague-Dawley rat. A fibrin glue application procedure was tested using this model. The double-blinded protocol called for spray application of saline or fibrin glue to mastectomy wounds followed by sequential inspection and necropsy on postoperative days 5, 8, 11, and 14. Topical fibrin glue was shown to be statistically significant in decreasing the presentation of seromas following a radical mastectomy in the Sprague-Dawley rat. (Arch Surg. 1990;125:305-307) References 1. Suen JY, Myers EN, eds. Cancer of the Head and Neck . New York, NY: Churchill Livingstone Inc; 1981:761-762. 2. Budd DC, Cochran RC, Sturtz DL, Fouty WJ. Surgical morbidity after mastectomy operations . Am JSurg . 1978;135:218-220.Crossref 3. Sitzmann JF, Dufresne C, Zuidema GD. The use of sclerotherapy for treatment of postmastectomy wound seromas . Surgery . 1983;93:345-347. 4. Say CC, Donegan W. A biostatistical evaluation of complications from mastectomy . Surg Gynecol Obstet . 1974;138:370-376. 5. Hayes JA, Bryan RM. Wound healing following mastectomy Aust N Z J Surg . 1984;54:25-27.Crossref 6. Urist MM, Maddox WA, Kennedy JE, Balch CM. Patient risk factors and surgical morbidity after regional lymphadenectomy in 204 melanoma patients . Cancer . 1983;51:2152-2156.Crossref 7. Aitken DR, Hunsaker R, James AG. Prevention of seromas following mastectomy and axillary dissection . Surg Gynecol Obstet . 1984;158:327-330. 8. Nichter LS, Morgan RF, Dufresne CR, Lambruschi P, Edgerton MT. Rapid management of persistent seromas by sclerotherapy . Ann Plast Surg . 1983;11:233-236.Crossref 9. Smith SRG, Gilmore OJA. Surgical drainage . Br J Hosp Med . 1985;72:308-311. 10. Spotnitz WD, Mintz PD, Avery N, Bithell TC, Kaul S, Nolan SP. Fibrin glue from stored human plasma: an inexpensive and efficient method for local blood bank preparation . Am JSurg . 1987;53:460-463. 11. Cronkite EP, Lozner EL, Deaver JM. Use of thrombin and fibrinogen in skin grafting . JAMA . 1944;124:976-978.Crossref 12. Ihara N, Suziki K, Tanaka H, et al. Application of fibrin glue to burns . Burns . 1984;10:396-404.Crossref 13. Jakob H, Campbell CD, Stemberger A, Wriedt-Lubbe I, Blumel G. Combined application of heterologous collagen and fibrin sealant for liver injuries . J Surg Res . 1984;36:571-577.Crossref 14. Keller J, Andreassen T, Joyce F, Knudsen V, Jorgensen P, Lucht U. Fixation of osteochondral fractures . Acta Orthop Scand . 1985;56:323-326.Crossref 15. Lupinetti FM, Alford WC, Glassford DM, Thomas CS. Cryoprecipitate—topical thrombin glue—initial experience in patients undergoing cardiac operations . J Thorac Cardiovasc Surg . 1985;90:502-505. 16. Stark J, deLeval M. Experience with fibrin seal in operations for congenital heart defects . Ann Thorac Surg . 1984;38:411-413.Crossref 17. Jakob H, Campbell CD, Qui ZK, Pick R, Replogle RL. Use of fibrin sealant for reinforcing arterial anastomoses . J Vasc Surg . 1984;1:171-180.Crossref 18. Rousou JA, Engelman RM, Breyer RH. Fibrin glue: an effective hemostatic agent for nonsuturable intraoperative bleeding . Ann Thorac Surg . 1984;38:409-410.Crossref 19. Maitland A, Williams WG, Coles JG, Freedom RM, Trusler GA. A method of treating serous fluid leak from a polytetraflouroethylene Blalock-Taussig shunt . J Thorac Cardiovasc Surg . 1985;90:791-793. 20. Jorgensen PH, Jensen KH, Andreassen B, Andreassen TT. Mechanical strength in rat incisional wounds treated with fibrin sealant . J Surg Res . 1987;42:237-241.Crossref 21. Staindl O. Tissue adhesion with highly concentrated human fibrinogen in otolaryngology . Ann Otol Rhinol Laryngol . 1979;88:413-418. 22. Goldman CD, Blocker SH, Ternberg JL, Crouch EC. Management of experimental presmothorax in weanling rabbits with the use of fibrin glue . Arch Surg . 1986;121:565-568.Crossref 23. Ishitani MB, McGahren ED, Sibley DA, Spotnitz WD, Rodgers BM. Laparoscopically applied fibrin glue in experimental liver trauma . J Pediatr Surg . 1989;24:867-871.Crossref 24. Matras H. Fibrin seal: the state of the art . J Oral Maxillofac Surg . 1985;43:605-611.Crossref 25. Baker JW, Spotnitz WD, Matthew TL, Fechner RD, Nolan SP. Mediastinal fibrin glue: hemostatic effect and tissue response in calves . Ann Thorac Surg . 1989;47:450-452.Crossref
Archives of Surgery – American Medical Association
Published: Mar 1, 1990
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