| Objective To evaluate the clinical effect of Patent Blue V on lymphorrhea after operations in foldinguen's space. To use Patent Blue V to prevent or cure lymphorrhea,so we can lower the incidenceof lymphorrhea at the most.Background Lymphorrhea or seroma is a common side effect after operations infold inguen space In China, many patients are operated in fold inguen space to curedifferent diseases, this procedure has proved a high incidence of lymphorrhea or seroma rangedbetween 15-53% in the literature. After operations in fold inguen space, although postoperativelymphorrhea or scroma is not considered as major lift-threatening complications,its occurrence can lead to lymphedema, sepsis, necrosis and delayed wound-healing process. Italso remains the main cause for prolonged hospital stay and frequent visits to the outpatient clinic,and finally, increase the post operative medical cost.The number of lymph nodes, obesity ofpatients, neoadjuvant therapy and surgical procedure are associated with lymphorrhea, however,these predicting factors can not be changed, three postoperative factors are significantlyimplicated in the pathogenesis of lymphorrhea: hematic exudation, presence of space andlymphatic block. Prevention of lymphorrhea requires meticulous haemostasis, reduction of thesurgical detachment spaces and improvement of lymph drainage o Despite the common use ofpostoperative drainage with vacuum drains, the risk persists. Many procedures have been proposedto decrease the incidence of lymphorrhea, such as the use of multiple drains, compressive dressing,but the mean incidence of lymphorrhea is also about 35%. Is there a new possibility that coulddecrease the occurrence of lymphorrhea after surgical treatment in fold inguen's space? PatentBlue V, a biologic preparation, that can be to indicate lymphorrhea in wound surfaces afterdissection and to help to solve this problem.Methods This was a prospective simple-blind randomized controlled trial.Fourty patientsundergoing operated in fold inguen's space from March 2006 to December 2006 were randomizedinto two group: control group (n=20)without Patent Blue V and treatment group (n=20) with 2.mlOf Patent Blue V applied to the dissection area at the begin of the surgical procedure. For eachgroup, the mean daily postoperative drainage volume, the mean cumulative drainage quantity 4days after operation and the incidence of lymphorrhea were reported. The analysis was used toevaluate the medical effect of Patent Blue V in surgery in fold inguen's space. Patent Blue V isnow increasingly used in several different surgical fields, such as gynecologysurgery, general surgery, plastic and reconstructive surgery, and urinary surgery. It has been usedsuccessfully in the treatment of lymphorrhea after surgical treatment in fold inguen's space Itwas logical to hope that application of Patent Blue V after operations in fold inguen's spacewould reduce lymphorrhea, possibly through its positive effects on the wound-healing process and haemostasis.Results The mean daily postoperative drainage was significantly greater in control group (P＜0.05). The mean cumulative drainage quantity 4 days after the operation was 125.1±23.7ml and369.9±31.7ml in treatment group and control group respectively, the reduction of cumulativedrainage was 66.18% (P＜0.05).The incidence of lymphorrhea was 0% (0 cases) and 10% (2 cases)in treatment group and control group respectively. (P＜0.05). One wound complications (50%)occurred in patients with postoperative lymphorrhea, and 0(0%) occurred in those withoutpostoperative lymphorrhea (P＜0.01).The total drainage duration and mean postoperative hospitalstay was 10.2±2.5 and 19.5±4.5 days in lymphorrhea group, there were 3.5±0.8 and 7.6±1.2days in goupe without lymphorrhea (P＜0.05).Conclusion Patent Blue V can reduce the daily and total cumulative postoperative drainage volume,and decrease the incidence of postoperative lymphorrhea after operation in fold inguen's space.
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