Evidence map›Paper›PMID 38038792›Full record

SynthesisAnnals of surgical oncology2024

Prevention of Seroma Formation and Its Sequelae After Axillary Lymph Node Dissection: An Up-to-Date Systematic Review and Guideline for Surgeons.

Merel A Spiekerman van Weezelenburg, Maikel J A M Bakens, Jean H T Daemen, Loeki Aldenhoven, Elisabeth R M van Haaren, Alfred Janssen, Yvonne L J Vissers, Geerard L Beets, James van Bastelaar

Open access · greenAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Annals of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.9field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Merel A Spiekerman van WeezelenburgDepartment of Surgery, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands. m.spiekermanvanweezelenburg@zuyderland.nl.ORCID http://orcid.org/0000-0002-1863-7857
Maikel J A M BakensDepartment of Surgery, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands.
Jean H T DaemenDepartment of Surgery, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands.
Loeki AldenhovenDepartment of Surgery, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands.
Elisabeth R M van HaarenDepartment of Surgery, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands.
Alfred JanssenDepartment of Surgery, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands.
Yvonne L J VissersDepartment of Surgery, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands.
Geerard L BeetsDepartment of Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands.
James van BastelaarDepartment of Surgery, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands.
Zuyderland Medisch Centrum · NLThe Netherlands Cancer Institute · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSeroma formation after axillary lymph node dissection (ALND) remains a troublesome complication with significant morbidity. Numerous studies have tried to identify techniques to prevent seroma formation. The aim of this systematic review and network meta-analysis is to use available literature to identify the best intervention for prevention of seroma after standalone ALND.

methodsA literature search was performed for all comparative articles regarding seroma formation in patients undergoing a standalone ALND or ALND with breast-conserving surgery in the last 25 years. Data regarding seroma formation, clinically significant seroma (CSS), surgical site infections (SSI), and hematomas were collected. The network meta-analysis was performed using a random effects model and the level of inconsistency was evaluated using the Bucher method.

resultsA total of 19 articles with 1962 patients were included. Ten different techniques to prevent seroma formation were described. When combining direct and indirect comparisons, axillary drainage until output is less than 50 ml per 24 h for two consecutive days results in significantly less CSS. The use of energy sealing devices, padding, tissue glue, or patches did not significantly reduce the incidence of CSS. When comparing the different techniques with regard to SSIs, no statistically significant differences were seen.

conclusionsTo prevent CSS after ALND, axillary drainage is the most valuable and scientifically proven measure. On the basis of the results of this systematic review with network meta-analysis, removing the drain when output is < 50 ml per 24 h for two consecutive days irrespective of duration seems best. Since drainage policies vary widely, an evidence-based guideline is needed.

Indexed as

AxillaBreast NeoplasmsLymph Node ExcisionSeromaDrainageFemaleHumansMastectomy, SegmentalPostoperative ComplicationsPractice Guidelines as TopicPrognosisSurgeonsSurgical Wound InfectionAxillary lymph node dissectionAxillary paddingDrainEnergy devicesSeromaTissue glue

Identifiers

PMID38038792
OpenAlexW4389223333

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.