Efficacy of fibrin sealants in preventing seroma formation following surgery for breast cancer: A systematic review and meta-analysis.

[INTRODUCTION] Breast surgery is often complicated by postoperative seroma, with incidence rates varying from 3% to 85% and no evidence-based prevention methods available. Fibrin glue plays an important role in promoting wound healing and reducing seroma formation. It reduces disruption of small blood and lymphatic vessels, thereby reducing seroma output and promoting effective hemostasis. Our aim was to evaluate the efficacy of fibrin sealant in reducing the incidence of seroma in patients undergoing surgery for breast cancer.

[METHODS] A research protocol was developed for this systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A comprehensive literature search was conducted using PubMed and Google Scholar. Medical subject heading terms used in the PubMed search included "fibrin tissue adhesive," ("mastectomy," or "breast surgery") and "randomized controlled trial."

[RESULTS] Sixteen studies were found with two primary findings: 1) Total drainage volume: Analysis of 13 studies showed a significant reduction in total drainage volume in patients treated with fibrin sealant compared with controls (mean difference, -2.18 mL; 95% confidence interval [CI]: -2.91, -1.46; P < 0.00001) and significant between studies. Diversity (I2=94%); 2). Incidence of seroma formation: An analysis of nine studies showed a 38% reduction in the odds of seroma formation with the use of fibrin sealant (odds ratio: 0.62; 95% CI: 0.40, 0.94; P = 0.02) and low heterogeneity (I2=6%).

[CONCLUSION] This meta-analysis provides evidence supporting the use of fibrin sealants in breast cancer surgery, as seen by the reduction in drainage volume, suggesting potential benefits such as improved patient comfort and shorter hospital stay.