title: Seroma prevention using an albumin-glutaraldehyde-based tissue adhesive in the rat mastectomy model.
abstract: Seroma formation is a common postoperative complication in plastic surgery, resulting in notable patient morbidity and expense. In this study the authors investigated the efficacy of a synthetic glutaraldehyde-based tissue adhesive (BioGlue; Cryolife, Inc., Kennesaw, GA) in seroma prevention in the rat mastectomy seroma model. This tissue adhesive is composed of purified bovine serum albumin (45%) and glutaraldehyde (10%). Twenty-two Sprague-Dawley rats received mastectomies along with axillary lymphadenectomy and disruption of subcutaneous lymphatics. The control group (N = 11) received 2.5 ml saline into the wound before closure. In the experimental group (N = 11), 2.5 ml BioGlue was injected into the wound. On postoperative day 7, the resultant seromas were quantified and adjacent tissues were harvested for histological examination. The rats in the control group had a mean seroma volume of 5.19 ml (standard deviation, +/- 3.65 ml; N = 11), whereas the rats treated with BioGlue had a mean seroma volume of 0.25 +/- 0.43 ml (N = 11). Histology revealed an inflammatory response consistent with postoperative changes as well as a mild foreign body reaction. This study demonstrates that BioGlue can be used as a tissue adhesive that reduces seroma formation significantly in the rat mastectomy model (p = 0.0008). Further studies are warranted to investigate the long-term effect of BioGlue on surrounding tissue.
authors.affiliation: Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Maryland, School of Medicine, Baltimore, USA.
authors.forename: Nathan G
authors.initials: NG
authors.lastname: Menon
authors.forename: Stephen
authors.initials: S
authors.lastname: Downing
authors.forename: Nelson H
authors.initials: NH
authors.lastname: Goldberg
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Silverman
mesh_terms: D000418:Albumins / Q000494:pharmacology; D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D005976:Glutaral / Q000494:pharmacology*; D006406:Hematoma / Q000209:etiology / Q000517:prevention & control*; D008408:Mastectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D011336:Probability; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D012016:Reference Values; D012680:Sensitivity and Specificity; D014014:Tissue Adhesives / Q000494:pharmacology; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
chemical_list: D000418:Albumins; D014014:Tissue Adhesives; D005976:Glutaral