Role of Absorbable Polysaccharide Hemostatic Powder in the Prevention of Complications After Axillary Lymph Node Dissection in Breast Cancer Patients: A Multicenter Retrospective Analysis

<i>Background and Objectives</i>: Although breast surgery has undergone a drastic de-escalation in recent decades, axillary dissection is still indicated in some selected cases. Unfortunately, in 3–85% of cases, complications such as seroma formation occur, highlighting the need for more...

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Main Authors: Simona Parisi, Francesco Saverio Lucido, Francesca Fisone, Roberto Ruggiero, Salvatore Tolone, Francesco Iovino, Antonio Santoriello, Federico Maria Mongardini, Maddalena Paolicelli, Ludovico Docimo, Claudio Gambardella
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Language:English
Published: MDPI AG 2025-01-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/1/79
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author Simona Parisi
Francesco Saverio Lucido
Francesca Fisone
Roberto Ruggiero
Salvatore Tolone
Francesco Iovino
Antonio Santoriello
Federico Maria Mongardini
Maddalena Paolicelli
Ludovico Docimo
Claudio Gambardella
author_facet Simona Parisi
Francesco Saverio Lucido
Francesca Fisone
Roberto Ruggiero
Salvatore Tolone
Francesco Iovino
Antonio Santoriello
Federico Maria Mongardini
Maddalena Paolicelli
Ludovico Docimo
Claudio Gambardella
author_sort Simona Parisi
collection DOAJ
description <i>Background and Objectives</i>: Although breast surgery has undergone a drastic de-escalation in recent decades, axillary dissection is still indicated in some selected cases. Unfortunately, in 3–85% of cases, complications such as seroma formation occur, highlighting the need for more accurate hemostasis systems. The aim of this study is to evaluate the effectiveness of absorbable polysaccharide hemostatic such as Haemocer<sup>TM</sup> in preventing postoperative seroma. <i>Materials and Methods</i>: Patients referred to two surgery centers for a diagnosed breast cancer and candidates for axillary lymph node dissection were retrospectively evaluated and included in Group A (treated with Haemocer<sup>TM</sup>) and B (control group). The primary endpoints were the drain output after 48 h, the daily amount just before the removal, and the duration of axillary drainage placement. Secondary endpoints included the presence of seroma at the ultrasound (US) follow-up, significant blood loss, hematoma, the duration of surgery, and postsurgical complications. <i>Results</i>: The drain output within 48 h was 196 ± 93 vs. 286 ± 38 mL in Groups A and B, respectively (<i>p</i> = 0.013). The daily output before the removal was 40 ± 7 mL in Group A and 47 ± 2 mL in Group B (<i>p</i> = 0.049). The duration of axillary drainage placement was shorter in the experimental group (7 ± 3 days) compared to the control group (10 ± 1 days) with a statistically significant difference (0.037). During the US follow-up, on days 7, 15, and 30, the number of patients affected by seroma and the volumes were lower in the experimental group. <i>Conclusions</i>: The adsorbable hemostatic powder proved to be effective both in reducing the volume of drained fluid postoperatively and in decreasing the number and volume of reported seromas during the US follow-up.
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spelling doaj-art-1e10189a8a6747ac9f602b65f69179ec2025-01-24T13:40:30ZengMDPI AGMedicina1010-660X1648-91442025-01-016117910.3390/medicina61010079Role of Absorbable Polysaccharide Hemostatic Powder in the Prevention of Complications After Axillary Lymph Node Dissection in Breast Cancer Patients: A Multicenter Retrospective AnalysisSimona Parisi0Francesco Saverio Lucido1Francesca Fisone2Roberto Ruggiero3Salvatore Tolone4Francesco Iovino5Antonio Santoriello6Federico Maria Mongardini7Maddalena Paolicelli8Ludovico Docimo9Claudio Gambardella10Department of Advanced Since and Surgery, General, Mini-Invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, 80138 Naples, ItalyDepartment of Advanced Since and Surgery, General, Mini-Invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, 80138 Naples, ItalyDepartment of Advanced Since and Surgery, General, Mini-Invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, 80138 Naples, ItalyDepartment of Advanced Since and Surgery, General, Mini-Invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, 80138 Naples, ItalyDepartment of Advanced Since and Surgery, General, Mini-Invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, 80138 Naples, ItalyDepartment of Advanced Since and Surgery, General, Mini-Invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, 80138 Naples, ItalyDepartment of Surgery, Breast Unit, Luigi Cobellis Hospital, 84078 Vallo della Lucania, ItalyDepartment of Advanced Since and Surgery, General, Mini-Invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, 80138 Naples, ItalyDepartment of Advanced Since and Surgery, General, Mini-Invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, 80138 Naples, ItalyDepartment of Advanced Since and Surgery, General, Mini-Invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, 80138 Naples, ItalyDepartment of Advanced Since and Surgery, General, Mini-Invasive, Oncological and Obesity Surgery, Luigi Vanvitelli University of Campania, 80138 Naples, Italy<i>Background and Objectives</i>: Although breast surgery has undergone a drastic de-escalation in recent decades, axillary dissection is still indicated in some selected cases. Unfortunately, in 3–85% of cases, complications such as seroma formation occur, highlighting the need for more accurate hemostasis systems. The aim of this study is to evaluate the effectiveness of absorbable polysaccharide hemostatic such as Haemocer<sup>TM</sup> in preventing postoperative seroma. <i>Materials and Methods</i>: Patients referred to two surgery centers for a diagnosed breast cancer and candidates for axillary lymph node dissection were retrospectively evaluated and included in Group A (treated with Haemocer<sup>TM</sup>) and B (control group). The primary endpoints were the drain output after 48 h, the daily amount just before the removal, and the duration of axillary drainage placement. Secondary endpoints included the presence of seroma at the ultrasound (US) follow-up, significant blood loss, hematoma, the duration of surgery, and postsurgical complications. <i>Results</i>: The drain output within 48 h was 196 ± 93 vs. 286 ± 38 mL in Groups A and B, respectively (<i>p</i> = 0.013). The daily output before the removal was 40 ± 7 mL in Group A and 47 ± 2 mL in Group B (<i>p</i> = 0.049). The duration of axillary drainage placement was shorter in the experimental group (7 ± 3 days) compared to the control group (10 ± 1 days) with a statistically significant difference (0.037). During the US follow-up, on days 7, 15, and 30, the number of patients affected by seroma and the volumes were lower in the experimental group. <i>Conclusions</i>: The adsorbable hemostatic powder proved to be effective both in reducing the volume of drained fluid postoperatively and in decreasing the number and volume of reported seromas during the US follow-up.https://www.mdpi.com/1648-9144/61/1/79breast canceraxillary lymph node dissectionseromaabsorbable polysaccharide hemostatic
spellingShingle Simona Parisi
Francesco Saverio Lucido
Francesca Fisone
Roberto Ruggiero
Salvatore Tolone
Francesco Iovino
Antonio Santoriello
Federico Maria Mongardini
Maddalena Paolicelli
Ludovico Docimo
Claudio Gambardella
Role of Absorbable Polysaccharide Hemostatic Powder in the Prevention of Complications After Axillary Lymph Node Dissection in Breast Cancer Patients: A Multicenter Retrospective Analysis
Medicina
breast cancer
axillary lymph node dissection
seroma
absorbable polysaccharide hemostatic
title Role of Absorbable Polysaccharide Hemostatic Powder in the Prevention of Complications After Axillary Lymph Node Dissection in Breast Cancer Patients: A Multicenter Retrospective Analysis
title_full Role of Absorbable Polysaccharide Hemostatic Powder in the Prevention of Complications After Axillary Lymph Node Dissection in Breast Cancer Patients: A Multicenter Retrospective Analysis
title_fullStr Role of Absorbable Polysaccharide Hemostatic Powder in the Prevention of Complications After Axillary Lymph Node Dissection in Breast Cancer Patients: A Multicenter Retrospective Analysis
title_full_unstemmed Role of Absorbable Polysaccharide Hemostatic Powder in the Prevention of Complications After Axillary Lymph Node Dissection in Breast Cancer Patients: A Multicenter Retrospective Analysis
title_short Role of Absorbable Polysaccharide Hemostatic Powder in the Prevention of Complications After Axillary Lymph Node Dissection in Breast Cancer Patients: A Multicenter Retrospective Analysis
title_sort role of absorbable polysaccharide hemostatic powder in the prevention of complications after axillary lymph node dissection in breast cancer patients a multicenter retrospective analysis
topic breast cancer
axillary lymph node dissection
seroma
absorbable polysaccharide hemostatic
url https://www.mdpi.com/1648-9144/61/1/79
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