Comparing the effectiveness of tetracycline sclerotherapy versus placebo in the prevention of postmastectomy seroma among female patients in a tertiary hospital in Southern Nigeria
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Abstract
Background: Postmastectomy seroma is the commonest complication following mastectomy. It is a cause of significant morbidity for the patient and its management is challenging. Several attempts have been made to prevent or reduce the occurrence of postmastectomy seroma and the results have been inconclusive. Tetracycline is an effective sclerosant and has shown effectiveness in the management of seroma.
Aims: To evaluate the effectiveness of tetracycline sclerotherapy in the prevention of post-mastectomy seroma among women undergoing modified radical mastectomy for breast cancer.
Methods: Seventy-six (76) female patients with histological diagnosis of breast cancer were randomised into 2 groups. Following Auchincloss modified radical mastectomy, both groups had their wounds irrigated with distilled water. Group A in addition, had a suspension of tetracycline instilled. Daily measurements and recording of the drainage volume was done and drain was removed when drainage volume was less than 30mls per day on two consecutive days. The patients were assessed for post- operative pain and other wound complications.
Results: Most patients presented with advanced disease and the predominant histologic sub-type was invasive ductal carcinoma. Seroma was the most common complication followed by wound infection. The incidence of seroma was lower in the tetracycline group 1 (2.6%) than in the control group 5 (13.2%) though this difference did not reach statistical significant (p = 0.089). The application of topical tetracycline did not adversely affect healing of the wound.
Conclusion: Patients that had topical tetracycline applied to their wound following mastectomy had reduced incidence of seroma formation though not statistically significant.
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