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Effect of Microporous Polysaccharide Particles in Patients Undergoing Mastectomy
Julia M Selfridge1, Heather F Sinner1, Junmin Whiting2
1Department of Breast Oncology, H. Lee Moffitt Cancer Center, Moffitt Cancer Center, Tampa, FL.
Background:
Microporous polysaccharide particles (MPP, proprietary name "Arista AH"), derived from purified plant starch, are used to augment hemostasis at surgery. The effect of MPP regarding short-term complications after mastectomy remains an area of ongoing investigation.
Patients And Methods:
A single-institution, retrospective chart review of patients undergoing unilateral mastectomy without reconstruction from January 2019 to 2021 was performed. Primary endpoints included antibiotic prescription, seroma or abscess drainage, readmission, wound dehiscence, and time to drain removal within 30 days of initial surgery. Wilcoxon rank sum test or Student t test was used for group comparisons for continuous variables; Chi-square test or Fisher exact test was used to evaluate the associations among categorical variables.
Results:
One hundred ninety patients were included; 119 received MPP and 71 did not. There was no difference in antibiotic prescription, infection drainage, hematoma, readmission, dehiscence, or time to drain removal with regards to MPP use. MPP treated patients were older (65.8 years vs. 59.1, P < .001) and had lower albumin levels (4.1 g/dL vs. 4.3, P = .025). Patients who underwent abscess drainage had higher body mass index ( mean 36.1 vs. 30.1 P = .036). Patients requiring seroma drainage were more likely to be diabetic (12.8% vs. 4%, P = .035) and to have been treated with lymphovenous anastomosis (LVA, 15.6% vs. 3.8%, P = .009). Patients who had LVA were significantly less likely to receive MPP when compared to other groups (3.1% vs. 74.7% P < .001).
Conclusion:
Consider utilizing MPP in patients at higher risk of seroma, such as those undergoing axillary surgery including LVA.
Insights
Microporous polysaccharide particles (MPP) did not significantly affect short-term complications after mastectomy. However, MPP use was lower in patients undergoing lymphovenous anastomosis (LVA), who had higher seroma risk.
Area of Science:
- Surgical Innovation
- Biomaterials in Medicine
- Post-Mastectomy Care
Background:
- Microporous polysaccharide particles (MPP) are used to enhance surgical hemostasis.
- The impact of MPP on short-term complications following mastectomy requires further investigation.
Purpose of the Study:
- To evaluate the effect of MPP on short-term complications after mastectomy.
- To identify patient factors associated with MPP use and post-operative outcomes.
Main Methods:
- Retrospective chart review of 190 patients undergoing unilateral mastectomy without reconstruction.
- Primary endpoints included antibiotic use, drainage, readmission, wound dehiscence, and drain removal time.
- Statistical analysis using Wilcoxon rank sum, Student t, Chi-square, and Fisher exact tests.
Main Results:
- No significant difference in complications (antibiotic prescription, drainage, readmission, dehiscence) between MPP and non-MPP groups.
- MPP patients were older and had lower albumin levels.
- Higher BMI, diabetes, and lymphovenous anastomosis (LVA) were associated with increased drainage; LVA patients were less likely to receive MPP.
Conclusions:
- MPP did not alter short-term post-mastectomy complication rates in this cohort.
- Consider MPP for patients at higher risk of seroma, particularly those undergoing axillary surgery with LVA.
