Retrospective Evaluation of the Effectiveness of a Synthetic Glue and a Fibrin-Based Sealant for the Prevention of Seroma Following Axillary Dissection in Breast Cancer Patients

Introduction: Seroma formation represents one of the most frequent postoperativecomplications of axillary dissection in breast cancer (BC) patients. We aimed toretrospectively explore the effectiveness of the intraoperative use of a syntheticcyanoacrylate glue (specifically Glubran®2) vs. the intraoperative use of a fibrin sealant(specifically Tisseel) in reducing seroma formation compared to the use of nonsealant inBC patients who underwent breast surgery and axillary dissection.Materials and Methods: We conducted a retrospective, monocentric observationalstudy on BC patients who underwent axillary dissection associated with breast surgery.The axillary dissection was completed with the application of a closed suction drainand was preceded by the application of either Glubran®2 glue or Tisseel sealant ornonsealant. We analyzed the quantity of serum drained in the first 3 postoperative days,length of hospitalization, days of permanence of axillary drain, seroma development, andpresence of postoperative infection signs.Results: Forty-one BC patients were considered. Based on the device used duringthe surgical treatment, the patients were divided into three groups: group A (17patients), to whom suction axillary drain was applied; group B (7 patients), to whomTisseel and axillary suction drain were applied; and group C (17 patients), to whomGlubran®2 and axillary suction drain were applied. Among the three groups, wedid not find significant differences in terms of amount of serum drained in the first3 postoperative days, length of hospitalization, and incidence of seroma. Group Cmaintained the axillary drain in a significantly lower number of days compared tothe other two groups (p = 0.02); it also had a lower incidence of postoperativeinfections (6%) compared to group A (23%) and group B (57%) (p = 0.02).Conclusions: We did not find any evidence that the use of surgical gluesmay reduce theformation of seroma following axillary dissection in BC patients. Nevertheless, the use ofcyanoacrylate glue in association with closed suction axillary drain seems to contribute tothe reduction in days of axillary drain permanence and of postoperative infections, whichare known factors delaying the schedule of any adjuvant oncological therapies.