Use of Low-Thrombin Fibrin Sealant Glue After Axillary Lymphadenectomy for Breast Cancer to Reduce Hospital Length and Seroma.
Axillary lymphadenectomy for primary breast cancer produces a non-negligible rate of postoperative lymphorrhea, prolonged hospital stays, and multiple seroma punctures. We evaluated the impact of low-thrombin fibrin sealant glue on surgical wounds in patients undergoing axillary lymph node dissection for breast cancer.



We conducted an observational study of 149 patients who underwent axillary lymphadenectomy for primary breast cancer between January 2014 and December 2015. Data were obtained from 2 successive prospective studies. The hospital stay length and morbidity (seromas, punctures) were compared between 2 groups: patients who had padding sutures and low-thrombin fibrin sealant glue without drainage (n = 49) and patients with drainage alone (n = 100). Hospital costs were assessed from the hospital perspective.



The mean hospital stay length was shorter in the fibrin sealant group (2.6 vs. 4.7 days; P < .001). Seroma magnitude and punctures were similar in patients treated with fibrin sealant compared with patients with drainage alone. The rate of needle aspiration for seroma was similar irrespective of whether or not a drain or fibrin sealant was used (30.6% vs. 33.0%, P = .77).



Low-thrombin fibrin sealant glue does not significantly reduce the amount of fluid produced in the axilla after breast surgery; however, its systematic use may help reduce hospital stays and costs.
Division of Breast and Plastic Surgery, Department of Surgery, Gustave Roussy, Villejuif, France.
Angelica
A
Conversano
Division of Breast and Plastic Surgery, Department of Surgery, Gustave Roussy, Villejuif, France. Electronic address: chafika.mazouni@gustaveroussy.fr.
Chafika
C
Mazouni
Division of Breast and Plastic Surgery, Department of Surgery, Gustave Roussy, Villejuif, France.
Anne
A
Thomin
Department of Pharmacy, Gustave Roussy, Villejuif, France.
Amélie
A
Gaudin
Division of Breast and Plastic Surgery, Department of Surgery, Gustave Roussy, Villejuif, France.
Marie
M
Fournier
Division of Breast and Plastic Surgery, Department of Surgery, Gustave Roussy, Villejuif, France.
Françoise
F
Rimareix
Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Villejuif, France; CESP Centre for Research in Epidemiology and Population Health, INSERM U1018, Paris-Sud University, Villejuif, France.
Julia
J
Bonastre
D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D004322:Drainage; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008197:Lymph Node Excision / Q000009:adverse effects*; D008198:Lymph Nodes / Q000601:surgery*; D008408:Mastectomy / Q000009:adverse effects*; D011379:Prognosis; D011446:Prospective Studies; D049291:Seroma / Q000209:etiology / Q000517:prevention & control*; D013917:Thrombin / Q000627:therapeutic use*
D015718:Fibrin Tissue Adhesive; D006490:Hemostatics; D013917:Thrombin
Axillary dissection; Breast cancer; Fibrin glue; Padding suture; Seroma