Skip to main content
Log in

Sealing of Postoperative Axillary Leakage After Axillary Lymphadenectomy Using a Fibrin Glue Coated Collagen Patch: a Prospective Randomised Study

  • Conference Report
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Seroma formation after axillary lymphadenectomy in women with breast cancer remains a problem despite many efforts to reduce surgery-related morbidity. In a prospective, randomised, open, parallel-group, controlled clinical trial we evaluated the effect of a fibrin-glue coated collagen patch (TachoComb H®, Nycomed Pharma AS, Denmark) on volume and duration of postoperative axillary drainage, duration of hospital stay, and procedural safety. Sixty patients were included in the study. Patients did not differ with respect to general characteristics, such as age, body mass index, treatment modality, and tumor stage distribution. In 29 patients, a fibrin-glue coated collagen patch was applied from the apex axillae to the thoracic longus nerve and half a patch was applied to the lateral border of the axillary nerve-vessel bundle. Thirty-one patients were randomised to standard closure of the axillary lymphadenectomy area. The mean duration of axillary drainage was 3.8±1.9 days in the fibrin-glue treatment group and 3.9±1.8 days in the control group (p=NS). The mean total drainage volume was 338.5±251.8ml in the fibrin-glue treatment group and 370.8±314.6ml in the standard closure group (p=NS). The mean length of post-operative hospital stay was 9.1±2.7 days in the fibrin-glue treatment group and 9.3±3.6 days in the standard closure group (p=NS). Seven patients (25%) and eight patients (25%) were diagnosed with local inflammation in the fibrin-glue treatment group and the standard closure group, respectively (p=NS). Seroma formation after drain removal was found in 11 patients (39%) in the fibrin-glue treatment group and in 13 patients (42%) in the standard closure group (p=NS). In summary, we observed no statistically significant differences with respect to axillary drainage time, drainage volume, length of hospital stay, local inflammation, and seroma formation after drainage removal.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Woodworth PA, McBoyle MF, Helmer SD, Beamer RL: Seroma formation after breast cancer surgery: incidence and predicting factors. AmSurg 66: 444-450; discussion 450-451, 2000

    Google Scholar 

  2. Waclawiczek HW, Pimpl W: Lymph fistulae following lymph node dissections-prevention and treatment using fibrin gluing. Chirurg 57: 330-331, 1986

    Google Scholar 

  3. Budd DC, Cochran RC, Sturtz DL, Fouty WJ Jr: Surgical morbidity after mastectomy operations. Am J Surg 135: 218-220, 1978

    Google Scholar 

  4. Aitken DR, Minton JP: Complications associated with mastectomy. Surg Clinics N Am 63: 1332-1352, 1983

    Google Scholar 

  5. O'Dwyer PJ, O'Higgins NJ, James AG: Effect of closing dead space on incidence of seroma formation after mastectomy. Surg Gynec Obstet 172: 55-56, 1991

    Google Scholar 

  6. Coveney EC, O'Dwyer PJ, Geraghty JG, O'Higgins NJ: Effect of closing dead space on seroma formation after mastectomy: a prospective randomised clinical trial. Eur J Surg Oncol 19: 143-146, 1993

    Google Scholar 

  7. Dawson I, Stam L, Heslinga JM, Kalsbeek HL: Effect of shoulder immobilization on wound seroma and shoulder dysfunction following modified radical mastectomy: A randomized prospective clinical trial. Br J Surg 76: 311-312, 1989

    Google Scholar 

  8. Sitzmann JV, Dufresne C, Zuidema GD: The use of sclerotherapy for treatment of postmastectomy wound seromas. Surgery 93: 345-347, 1983

    Google Scholar 

  9. Rice DC, Morris SM, Sarr MG, Farnell MB, van Heerden JA, Grant CS, Rowland CM, Ilstrup DM, Donohue JH: Intraoperative topical tetracycline sclerotherapy following mastectomy: a prospective, randomized trial. J Surg Oncol 73: 224-227, 2000

    Google Scholar 

  10. Coons MS, Folliguet TA, Rodriguez C, Woloszyn TT, Tuchler RE, Marini CP: Prevention of seroma formation after dissection of musculocutaneous flaps. Am Surg 59: 215-218, 1993

    Google Scholar 

  11. Morris AM: A controlled trial of closed wound suction. Br J Surg 60: 357-359, 1973

    Google Scholar 

  12. Liu CD, McFadden DW: Overnight closed suction drainage after axillary lymphadenectomy for breast cancer. Am Surg 63: 868-870, 1997

    Google Scholar 

  13. Harada RN, Pressler VM, McNamara JJ: Fibrin-glue reduces seroma formation in the rat after mastectomy. Surg Gynecol Obstet 175: 450-454, 1992

    Google Scholar 

  14. Eroglu E, Oral S, Unal E, Kalayci M, Oksuz O, Tilmaz M: Reducing seroma formation with fibrin glue in an animal mastectomy model. Eur J Surg Oncol 22: 137-139, 1996

    Google Scholar 

  15. Lindsey WH, Becker DG, Hoare JR, Cantrell RW, Morgan RF: Comparison of topical fibrin glue, fibrinogen, and thrombin in preventing seroma formation in a rat model. Laryngoscope 105: 241-243, 1995

    Google Scholar 

  16. Wang JY, Goodman NC, Amiss LR Jr, Nguyen DH, Rodeheaver GT, Moore MM, Morgan RF, Abbott RD, Spotnitz WD: Seroma prevention in a rat mastectomy model: use of a light-activated fibrin sealant. Ann Plast Surg 37: 400-405, 1996

    Google Scholar 

  17. Lindsey WH, Masterson TM, Spotnitz WD, Wilhelm MC, Morgan RF: Seroma prevention using fibrin glue in a rat mastectomy model. Arch Surg 125: 305-307, 1990

    Google Scholar 

  18. Sanders RP, Goodman NC, Amiss LR Jr, Pierce RA, Moore MM, Marx G, Morgan RF, Spotnitz WD: Effect of fibrinogen and thrombin concentrations on mastectomy seroma prevention. J Surg Res 61: 65-70, 1996

    Google Scholar 

  19. Jonk A, van Dongen JA, Kroon BB: Prevention of seroma following axillary lymph node dissection or radical mastectomy: ineffectiveness of fibrin-glue sealing technique. Neth J Surg 39: 135, 1987

    Google Scholar 

  20. Uden P, Aspegren K, Balldin G, Garne JP, Larsson SA: Fibrin adhesive in radical mastectomy. Eur J Surg 159: 263-265, 1993

    Google Scholar 

  21. Moore MM, Nguyen DH, Spotnitz WD: Fibrin sealant reduces serous drainage and allows for earlier drain removal after axillary dissection: a randomized prospective trial. Am Surg 63: 97-102, 1997

    Google Scholar 

  22. Gilly FN, Francois Y, Sayag-Beaujard AC, Glehen O, Brachet A, Vignal J: Prevention of lymphorrhea by means of fibr in glue after axillary lymphadenectomy in breast cancer: prospective randomized trial. Eur Surg Res 30: 439-443, 1998

    Google Scholar 

  23. Medl M, Mayerhofer K, Peters-Engl C, Mahrhofer P, Huber S, Buxbaum P, Sevelda P, Leodolter S: The application of fibringlue after axillary lymphadenectomy in the surgical treatment of human breast cancer. Anticancer Res 15: 2843-2845, 1995

    Google Scholar 

  24. Vaxman F, Kolbe A, Stricher F, Zund D, Volkmar P, Gros D, Grenier JF: Does fibrin-glue improve drainage after axillary lymph node dissection? Prospective and randomized study in humans. Eur Surg Res 27: 346-352, 1995

    Google Scholar 

  25. Furrer M, Inderbitzi R, Nachbur B: Does administration of fibrin glue prevent development of lymphoceles after radical lymphadenectomy? Chirurg 64: 1044-1049, 1993

    Google Scholar 

  26. Moore MM, Freeman MG: Fibr in sealant in breast surgery. J Long Term Eff Med Implants 8: 133-142, 1998

    Google Scholar 

  27. Burak WE Jr, Goodman PS, Young DC, Farrar WB: Seroma formation following axillary dissection for breast cancer: risk factors and lack of influence of bovine thrombin. J Surg Oncol 64: 27-31, 1997

    Google Scholar 

  28. Agus GB, Bono AV, Mira E, Olivero S, Peilowich A, Homdrum E, Benelli C: Hemostatic efficacy and safety of TachoComb in surgery. Ready to use and rapid hemostatic agent. Int Surg 81: 316-319, 1996

    Google Scholar 

  29. Schiele U, Kuntz G, Riegler A: Haemostyptic preparations on the basis of collagen alone and as fixed combination with fibrin glue. Clin Mater 9: 169-177, 1992

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Berger, A., Tempfer, C., Hartmann, B. et al. Sealing of Postoperative Axillary Leakage After Axillary Lymphadenectomy Using a Fibrin Glue Coated Collagen Patch: a Prospective Randomised Study. Breast Cancer Res Treat 67, 9–14 (2001). https://doi.org/10.1023/A:1010671209279

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1010671209279

Navigation