Effects of Wound Irrigation with Topical Phenytoin Solution During Modified Radical Mastectomy on Postoperative Seroma Formation

Background:Modified radicalmastectomy (MRM), as a surgical treatment inbreast cancer patients, may lead to important complications with significantmorbidities including seroma formation. In this study, we used topical phenytointo evaluate its impact on breast and axillary wound drainage and seroma formationafterMRM.Methods: In a double-blinded randomized clinical trial, patients with breastcancer who were candidates for modified radical mastectomy (MRM) wereenrolled. The patients were randomly assigned to two groups using a simplerandomization method. Group A received topical phenytoin ۱% solution for theirrigation of the mastectomy wound during the MRM procedure while group B(control group) underwent wound irrigation with normal saline solution. Inaddition to demographic data, postoperative variables including daily drainage ofbreast and axillary drains, drain removal days, and possible complicationsincluding seroma formation and their management were recorded.Results: Except for daily drainage recorded on the fifth postoperative day, thedrainage of both axillary and breast drains were significantly different betweengroupAandBin the following days. Compared to group B, axillary drains could beremoved significantly earlier in group A. In regard to the breast drains, they wereremoved earlier in group A with no statistically difference compared to group B,the difference was not statistically significant. Seroma was detected in ۷(۸.۳%)patients, ۳ patients in group A and ۴ patients in group B, with no significantdifferences between the two groups. All the patients underwent repeatedaspirations.Conclusions: Our findings showed that topical irrigation of the surgery sitewith phenytoin was effective in reducing axillary surgical wound drainage.