title: [Reduction of lymphatic drainage posterior to modified radical mastectomy with the application of fibrin glue].
abstract: OBJECTIVE
  Our objective was to investigate the effectiveness of fibrin glue to reduce hemato-lymphatic fluid production after modified radical mastectomy (MRM) in women with breast cancer.
  
  
  METHODS
  A total of 43 women treated surgically were randomly assigned to receive 10 ml of fibrin glue at the end of the breast resection plus closed suction drains (n = 22), or drain system only as a control group (n = 23). Outcome variables were fluid collected in the drainage system measured each 24 h. Drains were removed when a 50 ml output per day was obtained. Seroma formation and flap complications were also investigated.
  
  
  RESULTS
  The average age was 48.36 +/- 8.9 years for the study group and 52.87 +/- 9.74 years for the control group (p = 0.11). Body mass index (BMI) ranged between 22 and 35 kg/m2: 28.1 +/- 2.7 vs. 29.92 +/- 4.0 kg/m2 (p = 0.27). A reduction of the fluid drained was observed from the first postoperative day in the study group in contrast with the control (174.55 +/- 64.69 vs. 281.22 +/- 116.91, p = 0.001). A correlation between the BMI and the exposed surgical area was also statistically significant (p < 0.002), as well as the day the drains were extracted (p < 0.05). The incidence of seroma formation was 9% in the study group and 34.78% in the control, a statistically significant finding (p < 0.05).
  
  
  CONCLUSIONS
  Fibrin glue locally applied to the surgical wound under the flap and axilla significantly reduced the amount and duration of lymphatic fluid produced after MRM with axillary dissection. Also, a significant reduction in the incidence of seromas was observed.
authors.affiliation: Unidad de Investigación Médica en Epidemiología Clínica, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Segura-Castillo
authors.forename: Oscar
authors.initials: O
authors.lastname: Estrada-Rivera
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Castro-Cervantes
authors.forename: Ana Olivia
authors.initials: AO
authors.lastname: Cortés-Flores
authors.forename: Gabriela Abigail
authors.initials: GA
authors.lastname: Velázquez-Ramírez
authors.forename: Alejandro
authors.initials: A
authors.lastname: González-Ojeda
mesh_terms: D001943:Breast Neoplasms / Q000601:surgery; D004322:Drainage; D005260:Female; D015718:Fibrin Tissue Adhesive; D006490:Hemostatics; D006801:Humans; D008196:Lymph; D015409:Mastectomy, Radical / Q000009:adverse effects*; D008875:Middle Aged; D011182:Postoperative Care; D049291:Seroma / Q000209:etiology* / Q000517:prevention & control*
chemical_list: D015718:Fibrin Tissue Adhesive; D006490:Hemostatics