Effectiveness of TissuGlu in Reducing Seroma Formation and Postoperative Recovery in Mastectomy Patients: A Systematic Review and Meta-Analysis of Comparative Studies.

Postmastectomy complications, especially seroma formation, pose significant challenges to recovery and patient outcomes. TissuGlu, a lysine-urethane-based tissue adhesive, has been proposed as an alternative to standard wound closure (SWC) with drains to reduce seroma incidence and enhance recovery. However, its effectiveness remains debated. This meta-analysis assesses TissuGlu's impact compared to SWC in postmastectomy wound management. Following PRISMA guidelines, a systematic review and meta-analysis were conducted, including randomized controlled trials (RCTs) and observational studies published through August 2024 from databases including PubMed, Cochrane Library, Google Scholar, Embase, and Scopus. Six studies involving 408 patients (450 mastectomies) met inclusion criteria. Results indicated a significantly higher seroma incidence in the TissuGlu group than SWC (OR = 2.57, 95% CI, 1.20-5.52, P = .02), while no significant difference was observed in the number of mastectomies requiring aspiration (OR = 1.01, 95% CI, 0.29-3.51, P = .98). SWC showed benefits in fewer aspirations per mastectomy (WMD = 0.87, P = .003) and reduced aspiration volume (WMD = 110.83 mL, P = .04). TissuGlu notably reduced hospital stays (WMD = -2.44 days, P < .00001), suggesting improved recovery times. While SWC may better control postoperative fluid accumulation, TissuGlu holds promise in minimizing drain duration. Further high-quality RCTs are needed to establish the optimal role of TissuGlu, potentially in conjunction with drains, for improved postmastectomy outcomes.