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364108

Postmastectomy seroma: how much is it affected by serum levels of IL-6 and CRP and how much is it reduced by intravenous hydrocortisone injection?

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Last updated: 29 Dec 2024

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Abstract

Background
Seroma is extremely common after breast surgery, and this could be because of the inflammatory response during wound healing. Several factors such as interleukin-6 (IL-6) and C-reactive protein (CRP) have been detected in the seroma fluid that support this assumption; therefore, inhibition of the inflammatory response by using hydrocortisone might decrease seroma formation. We aimed to evaluate the effect of adding hydrocortisone to the anesthetic regimen in the perioperative serum level of IL-6 and CRP and consequently in postmastectomy seroma formation.
Patients and methods
The study included female patients with primary operable breast cancer who were randomly allocated to two groups; each included 40 patients. Patients in group I received general anesthesia with hydrocortisone, and patients in group II received general anesthesia without hydrocortisone. Venous samples were collected for measuring IL-6 serum levels before surgery, 6 h after the end of the procedure, and 24 h after the procedure and for measuring CRP serum levels before surgery and 24 h after the procedure. All patients were followed up postoperatively for registration of the total drainage volume until drain removal, timing of drain removal, incidence of seroma formation, and management of seroma.
Results
Patients in group I had a lower total drainage volume ( = 0.001), had the drain removed earlier ( = 0.009), and had a lower incidence of postmastectomy seroma formation ( = 0.005). Postoperative serum levels of IL-6 and CRP showed a significant decrease in group I compared with group II.
Conclusion
Postmastectomy seroma is likely a proinflammatory process and can be reduced by giving intravenous hydrocortisone on induction of anesthesia and 2 h later, which significantly decreases the inflammatory mediators (IL-6 and CRP) that significantly reduce the incidence of seroma.

DOI

10.4103/1110-1121.153366

Keywords

C-reactive protein, Hydrocortisone, Interleukin-6, mastectomy, postmastectomy seroma

Authors

First Name

Ahmed

Last Name

Talha

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Affiliation

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City

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Orcid

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First Name

Rabie

Last Name

Ramadan

MiddleName

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Affiliation

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Email

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City

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Orcid

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First Name

Shreif

Last Name

Abdelhamid

MiddleName

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Affiliation

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Email

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City

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Orcid

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First Name

Salwa

Last Name

Hamdi

MiddleName

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Affiliation

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Email

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City

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Orcid

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Volume

34

Article Issue

1

Related Issue

48927

Issue Date

2015-01-01

Receive Date

2014-08-24

Publish Date

2015-01-01

Print ISSN

1110-1121

Online ISSN

1687-7624

Link

https://ejsur.journals.ekb.eg/article_364108.html

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https://ejsur.journals.ekb.eg/service?article_code=364108

Order

364,108

Publication Type

Journal

Publication Title

The Egyptian Journal of Surgery

Publication Link

https://ejsur.journals.ekb.eg/

MainTitle

Postmastectomy seroma: how much is it affected by serum levels of IL-6 and CRP and how much is it reduced by intravenous hydrocortisone injection?

Details

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Article

Created At

21 Dec 2024