title: Flap adhesion and effect on postoperative complication rates using Tissuglu® in mastectomy patients.
abstract: BACKGROUND
  Post-mastectomy seroma and related complications are common problems in modern oncological surgery. Occurrence rates of up to 59% have been reported in literature. High-risk patients, that is, those who have undergone previous surgeries, present with a high body mass index, have had radiation or chemotherapy, present a particular challenge. Noninvasive measures such as fibrin-based sealants have thus far not been able to effectively reduce complications associated with fluid accumulation. A recent study using a lysine-derived urethane adhesive named TissuGlu® however, showed promising results in patients after abdominoplasty.
  
  
  METHODS
  32 consecutively recruited patients received a mastectomy using a gold standard mastectomy technique as well as TissuGlu® flap fixation. A control group of 173 patients, having received a gold standard mastectomy-only, was analyzed retrospectively, totaling 205 patients. Primary endpoints were post-discharge seroma formation and revision surgery/re-hospitalization. Secondary endpoints were initial seroma volume, postoperative pain, hematoma formation and day of drain removal.
  
  
  RESULTS
  No significant difference in seroma formation was demonstrated. The revision surgery/re-hospitalization rate was reduced from 6.9 to 0%, though this did not reach significance. Significant improvement could be shown in the TissuGlu® group regarding time to drain removal (17% decrease), and hematoma formation (14% decrease). No difference was shown in postoperative pain.
  
  
  CONCLUSIONS
  Although patient numbers are still small, advantages in revision surgery/re-hospitalization rate, hematoma formation as well as time to drain removal was shown for the TissuGlu® group.
  
  
  METHODS
  Therapeutic, IV.
authors: Department of Gynecology and Obstetrics, Holweide Hospital, Cologne, Germany. ceichler@gmail.com.|Brustzentrum, Krankenhaus Holweide, Neufelder Strasse 32, 51067, Köln, Germany. ceichler@gmail.com.
authors: Christian
authors: C
authors: Eichler
authors: Department of Gynecology and Obstetrics, Holweide Hospital, Cologne, Germany.|Department of Gynecology and Obstetrics, Hospital Düren GmbH, Düren, Germany.
authors: Petra
authors: P
authors: Fischer
authors: Brustzentrum, Krankenhaus Holweide, Neufelder Strasse 32, 51067, Köln, Germany.|Department of Gynecology and Obstetrics, Hospital Düren GmbH, Düren, Germany.
authors: Axel
authors: A
authors: Sauerwald
authors: Department of Gynecology and Obstetrics, Holweide Hospital, Cologne, Germany.|Department of Gynecology and Obstetrics, Hospital Düren GmbH, Düren, Germany.
authors: Faten
authors: F
authors: Dahdouh
authors: Brustzentrum, Krankenhaus Holweide, Neufelder Strasse 32, 51067, Köln, Germany.|Department of Gynecology and Obstetrics, University of Cologne, Cologne, Germany.
authors: Mathias
authors: M
authors: Warm
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000601:surgery*; D004322:Drainage; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D008408:Mastectomy / Q000009:adverse effects* / Q000379:methods*; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D049291:Seroma / Q000209:etiology; D013524:Surgical Flaps; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome
keywords: Breast cancer; Drain; Mastectomy; Prevention; Seroma; Time to drain removal; TissuGlu