Cyanoacrylate adhesive reduces seroma production after modified radical mastectomy or quadrantectomy with lymph node dissection – a prospective randomized clinical trial

• Published in: Clinical breast cancer 2017-12, Vol.17 (8), p.595-600
• Main Authors: Vasileiadou, K., MD, Kosmidis, C., MD, PhD, Anthimidis, G., MD, MSc, PhD, Miliaras, S., MD, Kostopoulos, I., MD, PhD, Fahantidis, E., MD, PhD
• Format: Article
• Language: English
• Subjects: Aged; Axilla; Breast cancer; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Case-Control Studies; Cyanoacrylate adhesive; Cyanoacrylates - therapeutic use; Drainage - statistics & numerical data; Female; Greece - epidemiology; Hematology, Oncology and Palliative Medicine; Humans; Incidence; Lymph Node Excision - adverse effects; Mastectomy; Mastectomy, Modified Radical - adverse effects; Mastectomy, Segmental - adverse effects; Middle Aged; Obstetrics and Gynecology; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative Complications - prevention & control; Prospective Studies; Seroma; Seroma - epidemiology; Seroma - etiology; Seroma - prevention & control; Surgical glue; Time Factors
• ISSN: 1526-8209; 1938-0666
• DOI: 10.1016/j.clbc.2017.04.004

Abstract Aims of the study Accumulation of seroma is a frequent complication after modified radical mastectomy or quadrantectomy with lymph node dissection. The aim of this study was to examine if a new adhesive material made of cyanoacrylate can effectively provide a sealing coat to tissues and thus reduce seroma production significantly. Methods This prospective, randomized case-control study consisted of 128 women diagnosed with breast cancer and scheduled for modified radical mastectomy or quadrantectomy with lymph node dissection in Thessaloniki, Greece. In 64 patients (cases), a cyanoacrylate adhesive was applied at the operative field after removal of the tumor and lymph nodes, while the remaining 64 patients served as controls. Results Seroma production (p=0.001), drainage duration (p=.0.001), and drainage amount (p=.0.001) were all significantly less for cases than controls. A stepwise multiple regression model incorporating the use of adhesive, BMI, tumor size, and number of infiltrated lymph nodes was deemed significant and was able to explain 51.6% of the variability in seroma amount. Conclusions The results of our study demonstrated that the cyanoacrylate adhesive can contribute to reduction of seroma produced after mastectomy and subsequently decrease the duration of post-operative drainage and the frequency of seroma aspirations. However, since the pathogenesis of seroma formation is multifaceted and complex, further research in larger samples is required to confirm the results of this study.