Prospective comparison of Sapylin and Avitene for reducing hydrops after axillary lymphadenectomy in breast cancer patients

J Surg Res. 2017 Apr:210:8-14. doi: 10.1016/j.jss.2016.10.032. Epub 2016 Nov 5.

Abstract

Background: This study compared the efficacy of Sapylin and Avitene in reducing postoperative axillary seroma formation and effusion when applied topically after axillary lymphadenectomy.

Methods: A total of 224 patients were randomly divided into a Sapylin treatment group (STG), an Avitene treatment group, and a control group (CG). All patients underwent axillary lymphadenectomy and were treated during surgery with Sapylin, Avitene, or neither according to their group assignment. The duration and amount of postoperative drainage, as well as the occurrence of seromas were recorded. Outcomes were compared by one-way analysis of variance and chi-square tests.

Results: Baseline patient data, including age, body mass index, history of neoadjuvant chemotherapy, type of surgery, number of resected lymph nodes, and number of positive metastases did not differ among the three groups. Patients in both the STG and the Avitene treatment group experienced significantly fewer days of drainage than those in the CG; there was no significant difference in drainage tube retention time between the two treated groups. The STG experienced significantly less drainage volume than the CG. Fewer patients in both treatment groups required seroma treatment or experienced complications compared with CG patients.

Conclusions: Both Sapylin and Avitene effectively reduced postoperative subcutaneous fluid accumulation after axillary lymphadenectomy. These treatments may be particularly useful for breast cancer patients at high risk of seroma formation, especially those with hypertension, diabetes mellitus, or a high body mass index who undergo axillary lymphadenectomy.

Keywords: Avitene; Axillary lymphadenectomy; Sapylin; Seroma.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Axilla
  • Biological Products / therapeutic use*
  • Breast Neoplasms / surgery*
  • Collagen / therapeutic use*
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Humans
  • Intraoperative Care / methods*
  • Lymph Node Excision*
  • Middle Aged
  • Postoperative Complications / prevention & control*
  • Prospective Studies
  • Seroma / etiology
  • Seroma / prevention & control*
  • Treatment Outcome

Substances

  • Biological Products
  • streptococcal preparation 722
  • Collagen