Microporous Polysaccharide Hemospheres and Seroma Formation After Mastectomy and Axillary Dissection in Rats

Abstract

Objective: Seroma is the most common complication after breast surgery. Several methods have been proposed to prevent seroma, but none of these provided a significant effect. A prolonged wound healing process is the most important cause of seroma. Microporous polysaccharide hemospheres (MPH) are used to achieve hemostasis. They may also accelerate wound healing. In this study, the effects of MPH on seroma formation were investigated. Material and Methods: Female Wistar rats weighing between 200 g and 250 g were used. There were eight rats in each of the control and study groups. Right breast mastectomy and axillary dissection were performed in all rats. While no application was performed after the operation in the control group, MPH was locally applied to the surgical site in the study group. Ten days after the operation, seroma fluid was aspirated and the total volume was recorded. The aspirates were analyzed and tissue samples were obtained from the surgical site. Results: Seroma was significantly lower in the study group (p=0.001). The mean albumin and lactate dehydrogenase levels were significantly lower in the study group (p=0.003). Pathological examination revealed that increase in fibrous tissue was significantly greater in the control group (p=0.032). Conclusion: MPH may reduce seroma after mastectomy. Turkish Başlık: Ratlarda Mastektomi ve Aksiller Diseksiyon Sonrası Mikro Gözenekli Polisakkarit Kürecikler Kullanımının Seroma Oluşumu Üzerine Etkisi Anahtar Kelimeler: Seroma, mastectomy, microporous polysaccharide hemospheres, wound healing Amaç: Seroma meme cerrahisi sonrasi en sık görülen komplikasyondur. Seroma oluşumunu önlemek için bazı yöntemler düşünülmüştür fakat bu yöntemlerin hiçbirinin belirgin bir etkisi olduğu gösterilememiştir. Uzamış yara iyileşme süreci seroma oluşumunun en önemli sebebidir. Hemostazı sağlamak için mikroporlu polisakkarid hemosferler (MPH) kullanılır. Bunlar ayrıca yara iyileşmesini hızlandırabilir. Bu çalışmada seroma oluşumunda MPH nin etkileri araştırılmıştır. Hastalar ve Yöntem: Ağırlığı 200g ile 250 g arasında değişen dişi Wistar sıçanları kullanıldı. Tüm çalışma ve kontrol gruplarında 8 sıçan vardı. Tüm sıçanlarda sağ meme mastektomisi ve aksiller disseksiyon yapıldı. Kontrol grubunda ameliyat sonrası hiçbir uygulama yapılmazken çalışma grubunda cerrahi sonrası lokal olarak MPH uygulandı. Ameliyattan 10 gün sonra seroma sıvısı aspire edildi toplam sıvı miktarı kaydedildi. Aspiratlar analiz edildi ve cerrahi sahadan doku örnekleri alındı. Sonuçlar: Çalışma grubunda seroma belirgin olarak az idi (p=0.001). Çalışma grubunda ortalama albümin ve LDH seviyeleri belirgin olarak düşük idi (p=0.003). Patolojik değerlendirme gösterdi ki kontrol grubunda fibröz dokuda belirgin artış vardı (p=0.32). Çıkarım: MPH mastektomi sonrası seroma gelişimini azaltabilir.

Keywords

• Seroma, mastectomy, microporous polysaccharide hemospheres, wound healing

Microporous Polysaccharide Hemospheres and Seroma Formation After Mastectomy and Axillary Dissection in Rats

Öz

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