Intraoperative topical tetracycline sclerotherapy following mastectomy: a prospective, randomized trial.
OBJECTIVE
Postoperative wound seromas are a frequent and troublesome occurrence after mastectomy. Recent reports have suggested the efficacy of topical sclerosants at reducing their formation.


METHODS
A prospective, randomized, double-blinded trial was performed to examine the effect of intraoperatively administered topical tetracycline on the occurrence of postoperative mastectomy seromas. Thirty-two women were randomized to the control arm (normal saline) and 30 women to the tetracycline arm. In the treatment group, 100 ml (2 g) of tetracycline solution was administered topically to the chest wall and skin flaps prior to skin closure. The control group received an equal volume of normal saline. Patients were monitored for the development of postoperative wound seroma.


RESULTS
There were no significant differences between groups regarding total volume of closed suction drainage, numbers of patients leaving hospital with drains in place, or duration of catheter drainage. Seroma formation 2 weeks postoperatively was greater in the tetracycline group than the control group (53% vs. 22%, P = 0.01). There were no differences between groups regarding the degree of postoperative pain, wound infection, or seroma formation 1 month postoperatively.


CONCLUSIONS
Topical tetracycline is not effective at preventing post-mastectomy wound seromas.
Rice
D C
DC
Department of Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Morris
S M
SM
Sarr
M G
MG
Farnell
M B
MB
van Heerden
J A
JA
Grant
C S
CS
Rowland
C M
CM
Ilstrup
D M
DM
Donohue
J H
JH
D000287:Administration, Topical; D001943:Breast Neoplasms / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000601:surgery; D002404:Catheterization / Q000295:instrumentation; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D004322:Drainage / Q000295:instrumentation; D005122:Exudates and Transudates; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care; D015411:Mastectomy, Modified Radical / Q000009:adverse effects; D010149:Postoperative Pain / Q000209:etiology; D011446:Prospective Studies; D011500:Protein Synthesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000627:therapeutic use*; D015911:Sclerotherapy; D012965:Sodium Chloride; D013396:Suction; D013530:Surgical Wound Infection / Q000209:etiology; D013752:Tetracycline / Q000008:administration & dosage / Q000627:therapeutic use*
D011500:Protein Synthesis Inhibitors; D012597:Sclerosing Solutions; D012965:Sodium Chloride; D013752:Tetracycline