A case control study on effect of 1% phenytoin irrigation during modified radical mastectomy at tertiary care centre
Journal Title: Medpulse International Journal of Surgery - Year 2019, Vol 10, Issue 3
Abstract
Background: Worldwide, breast cancer is the most frequently diagnosed life-threatening cancer in women. In less-developed countries, it is the leading cause of cancer death in women. Phenytoin is known to reduce incidence of seroma post mastectomy in breast cancer patient. Objectives: To see the effect of 1% phenytoin irrigation during Modified Radical Mastectomy at tertiary care centre. Material and Methods: This was a prospective randomized placebo control study was conducted at Sir Sayajirao General Hospital Baroda, Vadodara to study the effect of wound irrigation with 1% topical phenytoin during modified radical mastectomy on post-operative seroma formation, from September 2016 to September 2017. 36 patients were enrolled in the study, 18 were allotted to the phenytoin group and 18 allotted to the control group. Patients were followed for 1 month after surgery. Data was entered in Microsoft excel and analyzed using SPSS vr20. Results: 25% incidence of seroma was found amongst the patients undergoing modified radical mastectectomy. Significant association between irrigation with topical phenytoin and decrease in seroma formation was not established in present study. No local side effects of phenytoin solution were observed. The association of seroma formation with irrigation with topical phenytoin was not established in this study. The total drainage from the wound was lower in patients in the phenytoin group compared to the control group (400mlvs511ml). No significant decrease in the day of drain removal was reported between cases and control (7 vs 7.16 days). No significant difference between day of drain, duration of hospital stay was observed in patients in case group compared to patients in control group. It is observed that neoadjuvant therapy is a significant risk factor in seroma formation. 11 patients took neoadjuvant chemotherapy out of which 7 had seroma formation (54%). No significant difference is found between age of patients with seroma and patients without seroma and surgical site infection was noted in case group compared to control group. Conclusions: No significant benefit of phenytoin in preventing seroma was established in the present study.
Authors and Affiliations
Divyang H Chavda, Dhwani A Shah
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