Fibrin sealant does not decrease seroma output or time to drain removal following inguino-femoral lymph node dissection in melanoma patients: a randomized controlled trial (NCT00506311).
BACKGROUND
This study assessed the impact of closed suction drains and evaluated whether the intraoperative use of a fibrin sealant decreased time to drain removal and wound complications in melanoma patients undergoing inguino-femoral lymph node dissection.


METHODS
A pilot study (n = 18) assessed the impact of a closed suction drain following inguino-femoral lymph node dissection. A single-institution, prospective trial was then performed in which patients were randomized to a group that received intraoperative application of a fibrin sealant following inguino-femoral lymph node dissection or to a control group that did not receive sealant.


RESULTS
The majority of the patients enrolled felt the drains caused moderate or severe discomfort and difficulties with activities of daily living. Thirty patients were then randomized; the median time to drain removal in the control group (n = 14) was 30 days (range, 13-74) compared to 29 days (range, 11-45) in the fibrin sealant group (n = 16; P = 0.6). Major and minor complications were similar in the two groups.


CONCLUSIONS
Postoperative closed suction drains were associated with major patient inconvenience. Applying a fibrin sealant at the time of inguino-femoral lymph node dissection in melanoma patients did not reduce the time to drain removal or postoperative morbidity. Alternative strategies are needed.
Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA. mmmorten@mdanderson.org
Melinda M
MM
Mortenson
Yan
Y
Xing
Storm
S
Weaver
Jeffrey E
JE
Lee
Jeffrey E
JE
Gershenwald
Anthony
A
Lucci
Paul F
PF
Mansfield
Merrick I
MI
Ross
Janice N
JN
Cormier
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000191:economics; D006119:Groin; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects* / Q000191:economics; D008297:Male; D008545:Melanoma / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D049291:Seroma / Q000209:etiology / Q000517:prevention & control*; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery; D013396:Suction; D013997:Time Factors; D014014:Tissue Adhesives / Q000191:economics
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives