Role of Autologous Fibrin Glue (AFG) to Reduce Drainage Volume After Modified Radical Mastectomy for Breast Cancer

Abstract
Background: Seroma is arguably the most significant complication that can happen after mastectomy. Although seroma is not a life-threatening complication, this condition can lead to severe morbidities. This situation can cause prolonged hospital stays and delayed adjuvant therapy. In this regard, autologous fibrin glue is a hemostatic agent that can accelerate fibrin formation, stop vascular oozing, and decrease dead space. Therefore, this research was performed to evaluate autologous fibrin glue function in lowering seroma volume after mastectomy and shortening the length of hospital stay. Methods: This randomized control trial research was designed to compare the effect of autologous fibrin glue to a control group that did not receive autologous fibrin glue. Seroma volume was calculated every 24 hours. The drains were then removed after the production of seroma less than 30 mL/24 hours. Results: We recruited 20 patients for each of the two groups who met the inclusion criteria. Age, histopathology type, breast cancer stage, number of lymph nodes, and tumor size did not significantly differ. However, patients in the fibrin glue group had significantly lower cumulative drain production. The median seroma volume in the treatment group was 9.30 mL, while the median in the control group was 20.90 mL (p < 0.05). Conclusions: Autologous fibrin glue significantly decreased seroma formation and length of hospital stay.