Outcomes Associated With Fibrin Sealant Use in Lateral Neck Dissections

Abstract

Objective To determine whether the use of fibrin sealant tissue adhesives during lateral neck dissections is associated with a change in postoperative outcomes. Study Design Retrospective cohort. Setting Institutionally affiliated tertiary care center. Methods Various demographic, disease, and surgical data were collected for patients who underwent lateral neck dissections. Univariate regression analysis was performed with the following outcomes: total drain output and duration of drain placement, as well as incidence of postoperative infection, hematoma, seroma, chyle leak, and salivary leak. Results A total of 133 patients underwent lateral neck dissections. Fibrin sealant was used in 35% of cases (n = 46). Its use was not associated with differences in total drain output ( P = .77) or the number of days that the drains were in place ( P = .83). On secondary analysis, the use of fibrin sealant was not associated with a difference in postoperative incidence of hematoma ( P = .65), seroma ( P = .68), chyle leak ( P = .42), or salivary leak ( P = .73). These results were consistent when stratified by the presence of intraoperative complications. Its use accompanied an average cost of $674 per case. Conclusions Fibrin sealant use during lateral neck dissections was not associated with a reduction in drain output or days that the drains remained in situ. Although the current study was limited by sample size, fibrin sealant use was not associated with a decreased risk of postoperative adverse events. The evidence in this report suggests that the routine use of these products adds cost without clear benefit.