Examination of the effects of celecoxib on postmastectomy seroma and wound healing

Seroma is the liquid accumulation in the dead space following breast cancer surgery. The pathophysiology of seroma could not have been completely clarified until up to nowadays. Emergence of seroma causes a number of disadvantages among which are long hospitalization time, increase in expenses, ischemia in flaps, infections issuing from liquid accumulations and delay in adjuvant therapy. Seroma continues to be a current problem and the most common therapeutic methods are drainage for four up to five days following the surgery and frequently exercised aspirations.In the present study, it has been examined how celexocib, known to have anti-inflammatory, anti-angiogenic and anti-oxidant characteristics, is effective on seroma under the model of mastectomy exercised on female Wistar rats. Throughout the experimental process, 20 rats have been used, 10 for the control group, and 10 for the mastectomy group. Following the mastectomy, 0.25 cc/250gr (20 mg/kg/day) celecoxib was administired intraperitoneally on the celecoxib group, and saline of the same volume on the control group for 5 days. The weight of each rat was measured before the operation. Rats were observed for 10 days, their dynamism, arm movements, wound healing and infections, flap necrosis and seroma development being recorded. By the end of this process, seromas were aspired and rats were sacrified after certain tissue samples had been taken. Cases of fibrin, hemorrhage, edema, vascularization, congestion, PMNL (polymorphonuclear leukocytes), fibrose tissue increase, fibroblast, lymphocyte and macrophages were examined in the samples. As for the seroma liquids, acute phase reactant IL-1ß as a parameter of inflammation, and VEGF, the basic parameter of angiogenesis and blood vessel proliferation, were examined.By the end of the experiments, the biochemical analysis brought out for the celecoxib group that a significant decrease had occurred in the seroma volumes following the mastectomy (p=0,00 ;U=0,00), and that the level of IL-1ß in the seroma liquid had likewise decreased significantly (U=15,0; p=0,014); as for the histopathological analysis, an increase of congestion (x²=0,044) was detetected in the celecoxib group. Following the surgery, infection and wound expansion occured on a rat in the seroma group, and microorganisms were detected in histopathological examination on another rat in the control group, which led to their elimination from the study.In conclusion, it is stated that celecoxib causes a significant decrease in seroma volumes following the mastectomy; that it represses the acute phase reactant IL-1ß, and that this occurs under the influence of its anti-inflammatory characteristic. It is proposed as would be useful to observe the effects of celecoxib by exercising altering doses, on a greater population of test subjects.