effect of autologous fibrin glue [AFG] on fluid drainage after modified radical mastectomy

ABSTRACT

Patients who have modified radical mastectomy for breast carcinoma accumulate serosanguineous fluid, potentially resulting in seroma. Fibrin glue has been shown to be effective in reducing seroma formation in animal models, and in some studies on man. The objective of this study was to determine whether an autologous fibrin glue [AFG] is safe and effective when used as a sealant agents in this patients and to determine the dose response of these agent on the time and amount of fluid drainage. Fourty patients were included in this study. One hour before surgery the blood was withdrown from the patients to prepare AFG by using the ammonium sulphate precipitation method. After completion of modified radical mastectomy the patients were randomly divided into four groups each one contain ten cases. The first group was the control group, but in the second group AFG was used with 4mL in axillary site and 4mL at the skin flap site. In the third group 8mL was sprayed both in axillary site and skin flap site. The fourth group included cases to them l6mL of AFG were applied to the axillary site and 8 mL to the skin flap site. The wound was closed very rapidly after sealant application and two drains were left. Post operative antibiotic for three days was used to all cases beside close observation to daily fluid drainage for 12 days. The results showed that AFG application reduced the time to drain removal [5.4 +/- 2.4 days] and decrease the amount of fluid drainage of the fourth day of surgery more obviously in group 4 [492 +/- I89 ml.] and without complications related to the sealant. For that we recommended its use to all cases subjected to modified radical mastectomy