Surgeons operating on patient

NHS Fife is pioneering the use of a new surgical technique which enables patients undergoing a mastectomy to be safely discharged the same day.  

Breast cancer surgery, including mastectomy and axillary node clearance, usually requires patients to remain in hospital overnight after surgery. Patients are very often fitted with a drain to prevent fluid accumulating, which can be uncomfortable and increases the risk of infection at the wound site.

The surgical team at Queen Margaret Hospital in Dunfermline has become the first in Scotland to use fibrin tissue sealant in mastectomies and axillary node clearances. The new technique sees a form of tissue glue, which is commonly used in other types of surgery, applied on the inside of the breast to seal the tissue. By using fibrin tissue sealant, the amount of fluid produced is reduced both during and after surgery, and enables patients to be safely discharged home the same day without the need for a drain. 

Removing the need for a fluid drain provides a range of benefits for patients, improving comfort post-surgery whilst reducing the risk of the complications such as surgical site infections, seroma (fluid build-up under the skin) and haematoma (severe bruising). The technique also enables patients to be safely discharged earlier to recover at home and results in fewer trips to hospital as there is no drain to be removed. Patients who prefer to remain in hospital overnight following the procedure continue to have the option to do so if they wish.

Consultant Oncoplastic Breast Surgeon, Christopher Cartlidge, has led the development of this new approach in Fife. Mr Cartlidge said:

“Receiving a breast cancer diagnosis can be devastating and we want to do all we can to make sure any subsequent treatment is as person-centred and straightforward as possible.

“The use of fibrin tissue sealant during mastectomy procedures is a really important development – it means that we can quickly limit bleeding within the breast and means patients no longer require a drain in the days following the procedure. Not only is this much more comfortable, it also reduces the risk of infection and other complications.

“The feedback from patients has been excellent – people have really appreciated being able to go home within a matter of hours to start their recovery safely in familiar surroundings with their loved ones around them.“

NHS Fife Medical Director, Dr Christopher McKenna, added:

“While COVID-19 has resulted in significant challenges for all healthcare services, urgent cancer procedures in Fife continued throughout the pandemic.

“The majority of patients requiring a mastectomy want to be able to return home as quickly as possible, and this new procedure enables patients to do so safely whilst reducing the risk of complications at the same time. Importantly though, those who feel more reassured by remaining in hospital overnight will still have to option to do so.

“We always strive to put patients at the centre of everything we do, and developments such as this allow us to do exactly that.”