Flap adhesion and effect on postoperative complication rates using Tissuglu.sup.® in mastectomy patients

• Published in: Breast cancer (Tokyo, Japan) Vol. 23; no. 3; p. 486
• Main Authors: Eichler, Christian, Fischer, Petra, Sauerwald, Axel, Dahdouh, Faten, Warm, Mathias
• Format: Journal Article
• Language: English
• Published: Springer 01.05.2016
• Subjects: Analysis; Body mass index; Cancer; Chemotherapy; Fibrin; Lysine; Surgery; Urethanes
• ISSN: 1340-6868; 1880-4233
• DOI: 10.1007/s12282-015-0591-1

Introduction Post-mastectomy seroma and related complications are common problems in modern oncological surgery. Occurrence rates of up to 59 % have been reported in literature. High-risk patients, that is, those who have undergone previous surgeries, present with a high body mass index, have had radiation or chemotherapy, present a particular challenge. Noninvasive measures such as fibrin-based sealants have thus far not been able to effectively reduce complications associated with fluid accumulation. A recent study using a lysine-derived urethane adhesive named TissuGlu.sup.® however, showed promising results in patients after abdominoplasty. Methods 32 consecutively recruited patients received a mastectomy using a gold standard mastectomy technique as well as TissuGlu.sup.® flap fixation. A control group of 173 patients, having received a gold standard mastectomy-only, was analyzed retrospectively, totaling 205 patients. Primary endpoints were post-discharge seroma formation and revision surgery/re-hospitalization. Secondary endpoints were initial seroma volume, postoperative pain, hematoma formation and day of drain removal. Results No significant difference in seroma formation was demonstrated. The revision surgery/re-hospitalization rate was reduced from 6.9 to 0 %, though this did not reach significance. Significant improvement could be shown in the TissuGlu.sup.® group regarding time to drain removal (17 % decrease), and hematoma formation (14 % decrease). No difference was shown in postoperative pain. Conclusion Although patient numbers are still small, advantages in revision surgery/re-hospitalization rate, hematoma formation as well as time to drain removal was shown for the TissuGlu.sup.® group. Clinical question/level of evidence Therapeutic, IV.