Efficiency of Platelet Rich Plasma in Prevention of Seroma Formation in Patients with Mastectomy
AbstractObjective: Seroma is the most frequent complication after breast surgery which may sometimes lead to delay in wound healing and adjuvant therapies. We aimed to investigate the effect of platelet rich plasma in patients performed mastectomy which is proved to be effective on wound healing. Methods: Forty-one patients with breast cancer were included. All of them were performed mastectomy by the same surgical team and using electrocotery for flap dissection. After mastectomies and placing the drains, platelet rich plasma was sprayed on pectoralis muscle, under skin flaps, and incisions were closed by sutures routinely in 13 patients (study group). The control group (28 patients) and study group were followed-up by a blind surgeon to the groups and the drainage measures, drain removal dates and wound complications were recorded. Results: There were no differences between the groups in terms of mean axillary and flap drainage amounts, mean axillary and flap drains’ removal dates, and aspirated seroma amounts after drain removal. No other complications as infection or flap necrosis were recorded in both groups. Conclusion: In breast cancer, some complications related to surgery like poor wound healing and prolonged seroma formation, may cause delay in setting of adjuvant therapy. Platelet rich plasma is known to be effective in wound healing and we wanted to adapt its good sides for patients undergoing mastectomies. Although the results are promising in the study group, there were no differences statistically between two groups.
Qvamme G, Axelsson CK, Lanng C, Mortensen M, Wegeberg B, Okholm M, et al. Randomized clinical trial of prevention of seroma formation after mastectomy by local methylprednisolone injection. Br J Surg. 2015; 102: 1195-203.
Carless PA, Henry DA. Systematic review and meta-analysis of the use of fibrin sealant to prevent seroma formation after breast cancer surgery. Br J Surg. 2006; 93: 810-9.
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.
Athanassiou E, Vamvakopoulos N, Nakopoulou F, Fezoulidis I, Zaharoulis D, Spyridakis M et al. Use of albumin polymers during breast cancer surgery improves postoperative seroma outcome. Surg Technol Int. 2009; 18: 109-6.
Burnouf T, Goubran HA, Chen TM, Ou KL, El-Ekiaby M, Radosevic M. Blood-derived biomaterials and platelet growth factors in regenerative medicine. Blood Rev.2013; 27: 77-89.
Marx RE, Carlson ER, Eichstaedt RM, Schimmele SR, Strauss JE, Georgeff KR. Platelet-rich plasma: Growth factor enhancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998; 85: 638-46.
Eppley BL, Pietrzak WS, Blanton M. Platelet-rich plasma: a review of biology and applications in plastic surgery. Plast Reconstr Surg. 2006; 118: 147e-159e.
Ağalar C, Sevinç Aİ, Aysal A, Egeli T, Aksoy OS, Koçdor MA. Porcine dermal collagen prevents seroma formation after mastectomy and axillary dissection in rats. Eur J Breast Health. 2017; 13: 200-5.
Toyserkani NM, Jørgensen MG, Haugaard K, Sørensen JA. Seroma indicates increased risk of lymphedema following breast cancer treatment: A retrospective cohort study. Breast. 2017; 32: 102-4.
Khan MA. Effect of preoperative intravenous steroids on seroma formation after modified radical mastectomy. J Ayub Med Coll Abbottabad. 2017; 29: 207-10.
van Bastelaar J, van Roozendaal L, Granzier R, Beets G, Vissers Y. A systematic review of flap fixation techniques in reducing seroma formation and its sequelae after mastectomy. Breast Cancer Res Treat. 2018; 167: 409-16.
van Bastelaar J, Theunissen LLB, Snoeijs MGJ, Beets GL, Vissers YLJ. Flap Fixation Using Tissue Glue or Sutures Appears to Reduce Seroma Aspiration After Mastectomy for Breast Cancer. Clin Breast Cancer. 2017; 17: 316-21.
Sommeling CE, Heyneman A, Hoeksema H, Verbelen J, Stillaert FB, Monstrey S. The use of platelet-rich plasma in plastic surgery: a systematic review. J Plast Reconstr Aesthet Surg. 2013; 66: 301-11.
Takikawa M, Sumi Y, Ishihara M, et al. PRP&F/P MPs improved survival of dorsal paired pedicle skin flaps in rats. J Surg Res. 2011; 170: e189-96.
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