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Samir, Mohamed, Ramadan, Rabie. (1401). The Effect of Combining Flap Fixation with Gentamicin Lavage of the Surgical Bed for Reducing Postmastectomy Seroma: A Single-Institute Experience. سامانه مدیریت نشریات علمی, 13(2), 316-323. doi: 10.30476/mejc.2021.86956.1383
Mohamed Samir; Rabie Ramadan. "The Effect of Combining Flap Fixation with Gentamicin Lavage of the Surgical Bed for Reducing Postmastectomy Seroma: A Single-Institute Experience". سامانه مدیریت نشریات علمی, 13, 2, 1401, 316-323. doi: 10.30476/mejc.2021.86956.1383
Samir, Mohamed, Ramadan, Rabie. (1401). 'The Effect of Combining Flap Fixation with Gentamicin Lavage of the Surgical Bed for Reducing Postmastectomy Seroma: A Single-Institute Experience', سامانه مدیریت نشریات علمی, 13(2), pp. 316-323. doi: 10.30476/mejc.2021.86956.1383
Samir, Mohamed, Ramadan, Rabie. The Effect of Combining Flap Fixation with Gentamicin Lavage of the Surgical Bed for Reducing Postmastectomy Seroma: A Single-Institute Experience. سامانه مدیریت نشریات علمی, 1401; 13(2): 316-323. doi: 10.30476/mejc.2021.86956.1383

The Effect of Combining Flap Fixation with Gentamicin Lavage of the Surgical Bed for Reducing Postmastectomy Seroma: A Single-Institute Experience

Middle East Journal of Cancer
مقاله 13، دوره 13، شماره 2 - شماره پیاپی 50، تیر 2022، صفحه 316-323    اصل مقاله (144.14 K)
نوع مقاله: Original Article(s)
شناسه دیجیتال (DOI): 10.30476/mejc.2021.86956.1383
نویسندگان
Mohamed Samir؛ Rabie Ramadan*
Department of Surgery, Medical Research Institute, Alexandria University, Alexandria, Egypt
چکیده
Background: Seroma is the most prevalent complication after mastectomy and can lead to significant morbidity. No single method has been shown to be completely effective in reducing seroma rates. Flap fixation can reduce the dead space after mastectomy, thus decreasing the drainage volume and seroma rates. Gentamicin acts against Staphylococcus epidermidis involved in increasing drainage volume, duration, and seroma rates. This study aimed to evaluate the effect of combining flap fixation with gentamicin lavage of the surgical bed for reducing postmastectomy seroma.
Method: This prospective randomized controlled study included 100 women with breast cancer scheduled for modified radical mastectomy (MRM). The patients were allocated into the following four groups of 25: GI: flap fixation; GII: surgical bed lavage with gentamicin-containing solution; GIII: both techniques used in GI and GII; GIV: control group. The patients were followed up for the registration of drainage volume, timing of drain removal, and incidence of seroma.
Results: Total drainage volume was significantly lower; the drain was removed earlier and seroma rates were lower in group III than the other groups (P = 0.001, 0.009, and 0.005, respectively). Seroma in GIII was mild and managed with aspiration. In the other groups, seroma was more severe and required more aspirations, second tube drainage, or open drainage.
Conclusion: Combining flap fixation and gentamicin lavage of the surgical bed after MRM significantly decreased the amount of drained fluid, allowing an earlier removal of the drain and decreasing the incidence of seroma when compared with using each procedure alone. Moreover, the severity of seroma was significantly lower when both techniques were combined.
کلیدواژه‌ها
Flap fixation؛ Gentamicins؛ Lavage؛ Mastectomy؛ Postmastectomy seroma
اصل مقاله

How to cite this article:

Samir M, Ramadan R. The effect of combining flap fixation with gentamicin lavage of the surgical bed for reducing postmastectomy seroma: a single-institute experience. Middle East J Cancer. 2022;13(2):316-23. doi: 10.30476/mejc.2021.86956.1383.

مراجع
  1. Woodworth PA, McBoyle MF, Helmer SD, Beamer RL. Seroma formation after breast cancer surgery: incidence and predicting factors. Am Surg. 2000;66(5):444-51.
  2. Romrell LJ, Bland KI. Anatomy of the breast, axilla, chest wall and related metastatic sites. In: Bland KI, Copeland EM III, editors. The breast: comprehensive management of benign and malignant diseases. 3rd Philadelphia: WB Saunders; 2006.p.21-42.
  3. Sakkary MA. The value of mastectomy flap fixation in reducing fluid drainage and seroma formation in breast cancer patients. World J Surg Oncol. 2012;10:8.doi:10.1186/1477-7819-10-8.
  4. Agrawal A, Ayantunde AA, Cheung KL. Concepts of seroma formation and prevention in breast cancer surgery. ANZ J Surg. 2006; 76(12):1088-95. doi:10.1111/j.1445-2197.2006.03949.x.
  5. van Bemmel AJ, van de Velde CJ, Schmitz RF, Liefers GJ. Prevention of seroma formation after axillary dissection in breast cancer: a systematic review. Eur J Surg Oncol. 2011;37(10): 829-35. doi:10.1016/j.ejso.2011.04.012.
  6. Cortadellas T, Cordoba O, Espinosa-Bravo M, Mendoza-Santin C, Rodreguez-Fernandez J, Esgueva A, et al. Electrothermal bipolar vessel sealing system in axillary dissection: a prospective randomized clinical study. Int J Surg. 2011;9(8): 636-40. doi:10.1016/j.ijsu.2011.08.002.
  7. Manouras A, Markogiannakis H, Genetzakis M, Filippakis GM, Lagoudianakis EE, Kafiri G, et al. Modified radical mastectomy with axillary dissection using the electrothermal bipolar vessel sealing system. Arch Surg. 2008;143(6):575-80; discussion 581. doi:10.1001/archsurg.143.6.575.
  8. Jain PK, Sowdi R, Anderson AD, MacFie J. Randomized clinical trial Investigating the use of drains and fibrin sealant following surgery for breast cancer. Br J Surg. 2004;91(1):54-60. doi: 10.1002/bjs.4435.
  9. Talha A, Ramadan R, Abdelhamid SH, Hamdi S. Postmastectomy seroma: how much is it affected by serum levels of IL-6 and CRP and how much is it reduced by intravenous hydrocortisone injection? Egypt J Surg. 2015, 34:17–21. doi: 10.4103/1110-1121.153366.
  10. Halsted WS. Developments in skin grafting operation for cancer of the breast. JAMA. 1913;60:416.
  11. Purushotham AD, McLatchie E, Young D, George WD, Stallard S, Doughty J, et al.: Randomized clinical trial of no wound drains and early discharge in the treatment of women with breast cancer. Br J Surg. 2002;89(3):286-92. doi:10.1046/j.0007-1323.2001.
    x.
  12. Schuijtvlot M, Sahu AK, Cawthorn SJ. A prospective audit of the use of a buttress suture to reduce seroma formation following axillary node dissection without drains. Breast. 2002;11(1):94-6. doi:10.1054/brst.2001.0366.
  13. Iovino F, Auriemma PP, Ferraraccio F, Antoniol G, Barbarisi A. Preventing seroma formation after axillary dissection for breast cancer: a randomized clinical trial. Am J Surg. 2012;203(6):708-14. doi:10.1016/j.amjsurg.2011.06.051.
  14. Yetim I, Ozkan OV, Dervisoglu A, Erzurumlu K, Canbolant E. Effect of local gentamicin application on healing and wound infection in patients with modified radical mastectomy: a prospective randomized study. J Int Med Res. 2010;38(3):1029-33. doi:10.1177/147323001003800329.
  15. Ruiz-Tovar J, Cansado P, Perez-Soler M, Gomez MA, Llavero C, Calero P, et al. Effect of gentamicin lavage of the axillary surgical bed after lymph node dissection on drainage discharge volume. Breast. 2013;22(5):874-8. doi: 10.1016/j.breast.2013.03.008.
  16. Kuroi K, Shimozuma K, Taguchi T, Imai H, Yamashiro H, Ohsumi S, et al. Evidence-based risk factors for seroma formation in breast surgery. Jpn J Clin Oncol. 2006;36(4):197-206. doi: 10.1093/jjco/hyl019.
  17. Gonzalez EA, Saltzstein EC, Riedner CS, Nelson BK. Seroma formation following breast cancer surgery. Breast J. 2003;9(5):385-8. doi:10.1046/j.1524-4741.2003.09504.x.
  18. Hashemi E, Kaviani A, Najafi M, Ebrahimi M, Hooshmand H, Montazeri A. Seroma formation after surgery for breast cancer. World J Surg Oncol. 2004;2:44. doi: 10.1186/1477-7819-2-44.
  19. Kuroi K, Shimozuma K, Taguchi T, Imai H, Yamashiro H, Ohsumi S, et al. Pathophysiology of seroma in breast cancer. Breast Cancer. 2005;12(4):288-93. doi:
    2325/jbcs.12.288.
  20. Ruggiero R, Procaccini E, Piazza P, Docimo G, Iovino F, Antoniol G, et al. Effectiveness of fibrin glue in conjunction with collagen patches to reduce seroma formation after axillary lymphadenectomy for breast cancer. Am J Surg. 2008;196(2):170-4. doi:10.1016/j.amjsurg.2007.09.042.
  21. Larsen BB, Hugan C Jr. Fixation of skin flaps in radical mastectomy by subcutaneous sutures; observations. AMA Arch Surg. 1955;71(3):419-23.doi:10.1001/archsurg.1955.01270150113013.
  22. Purushotham AD, McLatchie E, Young D, George WD, Stallard S, Doughty J, et al. Randomized clinical trial of no wound drains and early discharge in the treatment of women with breast cancer. Br J Surg. 2002;89(3):286-92. doi: 10.1046/j.0007-1323.2001.02031.x.
  23. Throckmorton AD, Baddour LM, Hoskin TL, Boughey JC, Degnim AC. Microbiology of surgical site infections complicating breast surgery. Surg Infect (Larchmt). 2010;11(4):355-9. doi: 10.1089/sur.2009.029.
  24. Eklund AM, Valtonen M, Werkkala KA. Prophylaxis of sternal wound infections with gentamicin-collagen implant: randomized controlled study in cardiac surgery. J Hosp Infect. 2005;59(2):108-12. doi:10.1016/j.jhin.2004.10.005.
  25. Ruiz-Tovar J, Santos J, Arroyo A, Llavero C, Armanzas L, Lopez-Delgado A, et al. Effect of peritoneal lavage with clindamycin-gentamicin solution on infections alter elective colorectal cancer surgery. Surg Infect (Larchmt). 2016;17(1):65-70.doi:10.1089/sur.2015.064.
  26. Picó RB, Jiménez LA, Sánchez MC, Castelló CH, Bilbao AM, Arias MP, et al. Prospective study comparing the incidence of wound infection following appendectomy for acute appendicitis in children: conventional treatment versus using reabsorbable
    antibacterial suture or gentamicin-impregnated collagen sponges. Cir Pediatr. 2008;21(4):199-202.
  27. Bennett-Guerrero E, Pappas TN, Koltun WA, Fleshman JW, Lin M, Garg J, et al. Gentamicin-collagen sponge for infection prophylaxis in colorectal surgery. N Engl J Med. 2010;363(11):1038-49. doi: 10.1056/NEJMoa1000837.
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