No-drain mastectomy - Preventing seroma using TissuGlu®: A small case series

INTRODUCTION: Post-mastectomy seroma, with an occurrence of up to 59%, is a major complication in modern oncological surgery. While drain placement is a common tool in dealing with this complication, some patients may either be incapable or unwilling to accept this course of action, requiring an alternative option for seroma prevention. A recent study using a lysine-derived urethane adhesive named TissuGlu(®) has shown promising results in mastectomy patients. CASE PRESENTATION: We used TissuGlu(®) in three patients who could not have a post-operative drain after mastectomy due to a variety of reasons. Standard mastectomy protocols were followed. Two no-drain mastectomy patients did not show any post-operative seroma formation (cases 1 and 2), while a third patient had to be aspirated twice at two (180 ml) and four weeks (60 ml) post-surgery. No complications such as hematoma, wound dehiscence or adverse reactions to the adhesive were observed. Patient satisfaction with the no-drain situation was high as post-surgical discomfort was minimal. CONCLUSION: Although one patient developed small amounts of seroma, TissuGlu(®) may present an additional option in the high risk, no-drain post-mastectomy scenario.