title: No-drain mastectomy - Preventing seroma using TissuGlu(®): A small case series.
abstract: BACKGROUND
  Post-mastectomy seroma, with an occurrence of up to 59%, is a major complication in modern oncological surgery. While drain placement is a common tool in dealing with this complication, some patients may either be incapable or unwilling to accept this course of action, requiring an alternative option for seroma prevention. A recent study using a lysine-derived urethane adhesive named TissuGlu(®) has shown promising results in mastectomy patients.
  
  
  METHODS
  We used TissuGlu(®) in three patients who could not have a post-operative drain after mastectomy due to a variety of reasons. Standard mastectomy protocols were followed. Two no-drain mastectomy patients did not show any post-operative seroma formation (cases 1 and 2), while a third patient had to be aspirated twice at two (180 ml) and four weeks (60 ml) post-surgery. No complications such as hematoma, wound dehiscence or adverse reactions to the adhesive were observed. Patient satisfaction with the no-drain situation was high as post-surgical discomfort was minimal.
  
  
  CONCLUSIONS
  Although one patient developed small amounts of seroma, TissuGlu(®) may present an additional option in the high risk, no-drain post-mastectomy scenario.
authors.affiliation: Department of Gynecology and Obstetrics, Holweide Hospital, Cologne, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Eichler
authors.affiliation: Department of Gynecology and Obstetrics, Holweide Hospital, Cologne, Germany.
authors.forename: Faten
authors.initials: F
authors.lastname: Dahdouh
authors.affiliation: Department of Gynecology and Obstetrics, Holweide Hospital, Cologne, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Fischer
authors.affiliation: Department of Health, University of Witten/Herdecke, Witten, Germany.
authors.forename: Mathias
authors.initials: M
authors.lastname: Warm
keywords: Breast cancer; Mastectomy; No-drain; Prevention; Seroma; TissuGlu