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JCDR. 2021; 12(3): 1999-2005


ROLE OF TETRACYCLINE IN PREVENTION OF POST-MODIFIED RADICAL MASTECTOMY SEROMA; RANDOMIZED CONTROL STUDY

Moamen Mahrous El-Hosseiny, Wesam Mohamed Amr, Hazem Nour Abdellatif, Mohamed Abdallah Zaitoun.


Abstract

Breast cancer is the most frequent female cancer with an estimated 2 million new cases were diagnosed worldwide [1].
Nowadays, modified radical mastectomy (MRM) is the principal treatment of breast cancer, provides sufficient tumor clearance, and decrease the local recurrence rate [2].
Seroma is the commonest post-Mastectomy complication. and known as a collection of serous fluid combined with blood, plasma, and lymph fluid under the skin flap. As early sequel after MRM [3-4].
In the current literature incidence of postmastectomy seroma formation ranged from 3% up to 90% [3].
Seroma is the noisiest event for the patient and the surgeon. Seroma formation can lead to patient discomfort, repeated seroma aspirations with the risk of infection, prolonged hospital stay, delayed wound healing, skin flap necrosis, delay in receiving adjuvant therapies and extended hospital stay may be required which increases costs for the patient and healthcare system and higher surgical expenditures [5].
Despite numerous trials of new techniques which have attempted to reduce the incidence of seroma formation, no single method appears to be uniformly effective.
Recently, many researchers developed variable techniques to prevent seroma formation. reduction of dead space was the main principle of these techniques [6]. Variable methods for reduction of dead space were reported; use of suction drain, antibiotics like Tetracycline, adhesive tissue glues as fibrin glue, natural coagulation factors, and Octreotide [7].
Topical sclerotherapy with Tetracycline has long been used successfully in the treatment of malignant pleural effusions to cause obliteration of the pleural space [8]. The first report of Tetracycline sclerotherapy for treating seromas after mastectomy was by Sitzmann et al. [9].
In the current study we evaluate the effectiveness of using Tetracycline and closure of the dead space in reducing seroma after Modified Radical Mastectomy.






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