Randomized Single-Center Study of Effectiveness and Safety of a Resorbable Lysine-Based Urethane Adhesive for a Drain-Free Closure of the Abdominal Donor Site in a DIEP Flap Breast Reconstruction Procedure

J Invest Surg. 2022 Jun;35(6):1404-1414. doi: 10.1080/08941939.2022.2046215. Epub 2022 Mar 9.

Abstract

Objective: The hypothesis of this parallel group randomized trial testifies if TissuGlu is a safe and an effective alternative to the conventional drainage placement in regard to post-operative fluid management in the abdominal donor site for autologous (DIEP flap) breast reconstruction with a higher postoperative patient quality of life.

Patients and methods: Data was collected for 58 women who required to be at min.18 years old with a BMI < 30 and not taking any SSRIs (Selective Serotonin Reuptake Inhibitors).Exclusion criteria: Discharge with indwelling suction drains at the abdominal site or signs of wound infection during hospital stay.The patients were randomized into a study group (donor site closure with application of surgical adhesive without drains) and a control group (donor site closure with drains) using a randomly sorted sealed envelope system.Th e primary outcome was defined as the number of post-operative seroma formations.The secondary endpoint was the evaluation of patient satisfaction with both methods.

Results: 58 patients underwent a DIEP reconstruction (29 in the control- and 29 in the study group).Both groups were homogenous. Rate of seroma was 17%(5/29) in the study group and 10%(3/29) in the control group which showed no statistical significance (p-value = 0.71).Smoking and previous abdominal surgery turned out to be a risk factor for seroma formation in the study group.Overall satisfaction was evaluated with a questionnaire and was higher in the study group.

Conclusion: The abdominal closure with the surgical adhesive seems to be a safe procedure that contributes to patient satisfaction and increases the independence upon discharge in patients with adequate inclusion criteria.

Keywords: DIEP Flap; autologous breast reconstruction; seroma; surgical adhesive; tissue glue.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adhesives
  • Adolescent
  • Drainage / adverse effects
  • Drainage / methods
  • Female
  • Humans
  • Lysine
  • Mammaplasty* / adverse effects
  • Mammaplasty* / methods
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Quality of Life
  • Retrospective Studies
  • Seroma* / epidemiology
  • Seroma* / etiology
  • Seroma* / prevention & control
  • Urethane

Substances

  • Adhesives
  • Urethane
  • Lysine