A Study on Local Injection of Methylprednisolone Acetate to Prevent Seroma Formation after Mastectomy in 210 cases.

Abstract

The inflammatory process of seroma production, the most common postoperative complication following mastectomy, may be prevented with the use of local steroid injections. The impact of local steroid injection on seroma development was the focus of this research. This research compared the effects of saline on seroma development after mastectomy with those of a single 80 mg dose of methylprednisolone in a double-blind, randomised, placebo-controlled intervention trial. Mastectomy plus sentinel lymph node biopsy (M + SLNB) or mastectomy plus level I–II axillary lymph node dissection (M + ALND) were the more specific categories into which patients were placed based on the surgical axillary procedure. After the drain was removed on the first postoperative day, medications were introduced into the wound cavity via the drain hole. While the occurrence of side effects and problems were considered secondary objectives, seroma development constituted the main goal. In all, 210 women with primary breast cancer who were planned to have a mastectomy were considered. Following M + SLNB, a seroma formed in 32 out of 69 women (46 percent) in the group treated with methylprednisolone, compared to 52 out of 67 women (78 percent) in the group treated with saline (P < 0.001). In the intention-to-treat population, the methylprednisolone group had a much smaller mean cumulative seroma volume during the first 10 and 30 days. Methylprednisolone did not significantly affect seroma formation after M + ALND, and both the saline and methylprednisolone groups saw equal rates of seroma development. The infection rate was not different. The first day after M + SLNB, methylprednisolone was injected into the wound cavity. For the next 30 days, it significantly reduced the likelihood of seroma development. There was no such impact in the M + ALND group. More research is needed to determine whether greater or repeated dosages of methylprednisolone improve effectiveness.