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The composition of serous fluid after axillary dissection
J Bonnema1, D A Ligtenstein, T Wiggers
1Department of Surgical Oncology, University Hospital Rotterdam/Daniel den Hoed Cancer Center, The Netherlands.
The European Journal of Surgery = Acta Chirurgica
|March 9, 1999
Summary
Post-axillary dissection fluid initially contains blood and high creatine phosphokinase (CPK) levels. It then shifts to a lymph-like fluid with altered cells and proteins, preventing coagulation and aiding wound healing.
Area of Science:
- Biochemistry
- Oncology
- Surgical Pathology
Background:
- Axillary dissection is a common procedure in breast cancer treatment.
- Understanding the composition of post-operative serous fluid is crucial for managing fluid collection and optimizing wound healing.
- Previous studies have not fully characterized the dynamic changes in axillary drainage fluid composition.
Purpose of the Study:
- To analyze the chemical and cellular composition of serous fluid following axillary dissection.
- To compare the fluid's composition with blood and peripheral lymph.
- To elucidate the factors influencing fluid production and cessation.
Main Methods:
- A descriptive study was conducted at a university and teaching hospital.
- 16 patients undergoing axillary dissection for stage I or II breast cancer were included.
- Axillary drainage fluid was analyzed on postoperative days 1, 5, and 10 for chemical and cellular content.
Main Results:
- On postoperative day one, the drainage fluid exhibited blood components and elevated creatine phosphokinase (CPK).
- Subsequently, the fluid transformed into a composition resembling peripheral lymph, but with distinct cellular elements, higher protein concentration, and absence of fibrinogen.
- The lack of fibrinogen indicated an inability for coagulation.
Conclusions:
- The initial high CPK levels suggest a component of blood or tissue damage.
- The transition to a lymph-like fluid post-day one, with altered cellularity and protein content, is a key finding.
- Reduced fluid production is likely attributed to wound healing processes, including scar and connective tissue formation, rather than solely decreased fluid generation.