Effects of microporous polysaccharide hemosphere (Arista®) on seroma forming after mastectomy and axillary dissection in rats

Purpose: Seroma is the most common complication of breast surgery. (%10- 50) (1,2,3,4). It arises due to the dead-space after tissue dissection or excision. Recent studies show abnormal exudative fluid due to elongated inflamatory response and/or elongated first phase of wound healing is the most important factor constituting seroma (1,5,6,7). Seroma may cause serious complications such as wound infection, abscess, tissue necrosis ans sepsis. Microporus Polysaccharide Hemosphere (MPH(Arista®)) forms a concentrated gel matrix barrier and used for hemostasis when compress, knot tying and other methods fail. Purpose of this study is to show MPH can block lymphovascular leakage and accelerate wound healing by its polysaccharide structure and decrease seroma forming.Material and Method: Young female Wistar rats at the average weight of 200- 250 gr were used. Both control and study groups were involving 8 rats each. Right mastectomy and axillary dissection was performed and postoperatively control group had no applications beside local MPH was administered to study group. On postoperative day 10 seroma fluid was aspirated with steril injectors from mastectomy cavity and amount of fluid, laboratory parameters (total protein, albumin, Lactat dehydrogenas (LDH), hemogram, C reactive protein (CRP)) were measured. Under anesthesia rats were sacrified. Tissue samplings of operation area and pathological examinations were performed. Specimens were examined to confront vascular proliferation, amount of fibrin, edema, necrosis, congestion, microorganisms, polymorphonuclear leucocyts, fibroblasts, lymphocyts, macrophages and increase of fibrous tissue.Results: In control group seroma was observed significantly less (p= 0,001). Albumin and LDH, important components of exudative fluid, were significantly decreased in samples aspirated from study group (p<0,003). Also total protein was measured decreased in samples of study group. Pathological examination revealed in accordance with study group, increase of fibrous tissue was significantly more (p= 0,032). In addition, inflamatory cells existing especially in inflamatory phase of wound healing such as macrophages were observed in control group more.Conclusion: In this study it is shown that MPH blocks the lymphatic and vascular leakage after mastectomy and axillary dissection due to effects of its gel matrix barrier as well as accelerating wound healing with its polysaccharide structure and thereby decreases seroma incidence.Key Words: Seroma, mastectomy, wound healing, arista