title: Fibrin sealant decreases postoperative drainage in immediate breast reconstruction by deep inferior epigastric perforator flap after mastectomy with axillary dissection.
abstract: BACKGROUND
  Serosanguinous drainage after breast reconstruction by deep inferior epigastric perforator flap (DIEP) can limit patient's discharge. We introduced fibrin sealant in immediate breast reconstruction by DIEP flap to reduce drainage after mastectomy with axillary dissection.
  
  
  METHODS
  We performed an open study on 30 consecutive female aged from 28 to 63 years old. All underwent immediate breast reconstructions by DIEP flaps after mastectomy and axillary dissection for cancer. Patients were divided in group 1 (N = 15) without fibrin sealant and group 2 (N = 15) where the flap, thoracic, and axillary areas were sprayed with 5 mL of liquid fibrin sealant before drains insertion. There was no difference in the patient's BMI, height, weight or age between both the groups. Blake suction drains were placed under the flap and in the axillary area.
  
  
  RESULTS
  No adverse effects were reported, after a 20-month median follow-up. Drainage volumes or durations were not correlated to the patient's BMI, nor the height, weight or age. Thoracic drainage duration was longer than abdominal drainage in both the groups. Average drained volumes from the thoracic area were lower (427 vs. 552 mL; P = 0.015) and thoracic drains were removed earlier (5.47 vs. 6.33 days P = 0.022), in group 2 than in group 1. The length of stay was also reduced after the use of fibrin sealant (5.53 vs. 6.33 days; P = 0.032).
  
  
  CONCLUSIONS
  This study introduce the interest of fibrin sealant to significantly decrease the postoperative drainage volume and duration in the thoracic area after immediate breast reconstruction by DIEP flap.
authors.affiliation: Plastic Surgery Department, Henri Mondor Hospital, Creteil, France. mikaelhivelin@hotmail.com
authors.forename: Mikaël
authors.initials: M
authors.lastname: Hivelin
authors.forename: Jean Laurent
authors.initials: JL
authors.lastname: Heusse
authors.forename: Nadia
authors.initials: N
authors.lastname: Matar
authors.forename: Christophe
authors.initials: C
authors.lastname: Lepage
authors.forename: Laurent
authors.initials: L
authors.lastname: Lantieri
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000601:surgery; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D007902:Length of Stay; D008197:Lymph Node Excision; D016462:Mammaplasty; D015411:Mastectomy, Modified Radical; D008875:Middle Aged; D011184:Postoperative Period; D013524:Surgical Flaps; D014014:Tissue Adhesives / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives