Effect of Collagen-Enhanced Fibrin Sealant on Seroma Formation in a Rat Mastectomy Model

Background: Seromas are caused by leakage of lymphovascular fluid into postoperative dead space. This is the most common complication after reconstructive breast surgery. The purpose of this study is to demonstrate the utility of seroma-preventing substances by using a collagen-enhanced fibrin sealant on a rat mastectomy model. Methods: Thirty-six Sprague-Dawley rats were divided into three groups. After mastectomy and axillary lymph node dissection, normal sa-line was applied to the dead spaces in group 1 (control). In group 2, a collagen-enhanced fibrin sealant was applied, and in group 3, triam-cinolone acetate solution was applied. Afterwards, the amount of seroma was measured by three-dimensional micro-computed tomography (3D micro-CT) volumetry analysis and manual aspiration after 7 and 14 days, respectively. Results: The volume of seroma were significantly reduced in groups 2 and 3 compared to group 1 in both 3D micro-CT volumetry analysis and manual aspiration on postoperative day 7 (P<0.001). In addition, the results observed in day 14 also showed a decrease in the amount of seroma analyzed by CT in groups 2 and 3 compared to group 1 (P<0.05). In histopathologic examination inflammation was observed more frequently in group 1 and angiogenesis was more active in group 2. Conclusion: The use of a collagen-enhanced fibrin sealant (Collaseal) is as effective as triamcinolone control injected in a rat mastectomy model.