Study designs of evaluations included in the review
Randomised controlled trials (RCTs) were eligible for inclusion.
Specific interventions included in the review
Studies investigating fibrin sealant, delivered directly to the wound surface in liquid or aerosol form, were eligible for inclusion. Studies investigating bandages or pads impregnated with lyophilised fibrin sealant components were not included. The majority of the included studies investigated Tisseel or its market variants Tissucol and Haemaseel and, with the exception of one study, a spray device was used. The volume of sealant applied ranged from 2 to 24 mL.
Participants included in the review
Studies of women undergoing breast cancer surgery were eligible for inclusion. The most frequently performed surgery in the included studies was modified radical mastectomy (MRM); four studies exclusively investigated this population group. The remaining studies were of MRM, lumpectomy, axillary lymph node dissection, segmental mastectomy and total mastectomy. The mean or median age of the participants ranged from 50.9 to 73.0 years. The studies varied in the use of compression dressings, the number and type of drains, and the extent of shoulder mobilisation post-surgery.
Outcomes assessed in the review
Studies reporting the development of seroma and volume of drainage output as outcomes were eligible for inclusion. The secondary outcomes of interest were the number of drainage days, frequency of wound infection and length of stay in hospital.
How were decisions on the relevance of primary studies made?
The authors did not state how the papers were selected for the review, or how many reviewers performed the selection.