Intraoperative topical tetracycline sclerotherapy following mastectomy: A prospective, randomized trial

Background and Objectives: Postoperative wound seromas are a frequent and t roublesome occurrence after mastectomy. Recent reports have suggested the e fficacy of topical sclerosants at reducing their formation. Methods: A prospective, randomized, double-blinded trial was performed to e xamine the effect of intraoperatively administered topical tetracycline on the occurrence of postoperative mastectomy seromas. Thirty-two women were r andomized to the control arm (normal saline) and 30 women to the tetracycli ne arm. In the treatment group, 100 mi (2 g) of tetracycline solution was a dministered topically to the chest wall and skin flaps prior to skin closur e. The control group received an equal volume of normal saline. Patients we re monitored for the development of postoperative wound seroma. Results: There were no significant differences between groups regarding tot al volume of closed suction drainage, numbers of patients leaving hospital with drains in place, or duration of catheter drainage. Seroma formation 2 weeks postoperatively was greater in the tetracycline group than the contro l group (53% vs. 22%, P = 0.01). There were no differences between groups r egarding the degree of postoperative pain, wound infection, or seroma forma tion 1 month postoperatively. Conclusions: Topical tetracycline is not effective at preventing postmastec tomy wound seromas. (C) 2000 Wiley-Liss, Inc.