Examination of the Effects of Celecoxib on Postmastectomy Seroma and Wound Healing

Özet

Objectives: To examine the effect of celecoxib on wound healing and development of seroma after mastectomy.Seroma is an accumulation of serous fluid in dead space emerging after breast cancer surgery. The pathophysiology of seroma hasnot been clearly elucidated. Development of seroma leads to prolongation of hospital stay, increase in costs, ischemia of the flaps,infections due to fluid accumulation, and delayed adjuvant treatment.Seroma is still a current problem, and the most common treatment method for this problem is drainage and repeated aspirationsfor 5–7 days after surgery.Methods: The effect of celecoxib whose anti-inflammatory, antiangiogenic, and antioxidant effectiveness has been demonstratedin a mastectomy model applied on female Wistar rats has been investigated in the present study. A total of 20 rats including 10 ratsin the control and 10 in the celecoxib group were studied.Intraperitoneal 0.25 cc/250 g (20 mg/kg/day) celecoxib was administered to the celecoxib group for 5 days after mastectomy,and the same volume of physiological saline solution was given to the control group for 5 days. Rats were followed up for 10 daysafter surgery. During this process, vitality of the rats, movements of the extremities, wound healing conditions, wound infections,flap necrosis, and occurrence of seroma were recorded. At the end of this period, seromas were aspirated, tissue samples were retrieved,and the rats were sacrificed. Fibrin, hemorrhage, edema, vascularization, congestion, polymorphonuclear leukocytes, andincrease in fibrotic tissue fibroblasts, lymphocytes, and macrophages were evaluated in tissue samples.In seroma fluids, interleukin-1 beta (IL-1β), an acute phase reactant, and vascular endothelial growth factor, a vital parameter ofvascular proliferation and angiogenesis, were examined.Results: At the end of the experiments, the seroma volume decreased significantly in the celecoxib group (p=0.804; 0.001), the IL-1β level decreased significantly as detected in the biochemical examination (p=0.014), and in the histopathological examination,an increase in congestion in the celecoxib group was determined.Conclusion: In conclusion, celecoxib markedly decreased interleukin and the volume of seroma after mastectomy; suppressedthe level of an acute phase reactant, IL-1β; and demonstrated this effect through its anti-inflammatory activity. We believe that theeffects of celecoxib should be investigated using different dose applications and larger number of subjects.