Arnica montana and Bellis perennis for seroma reduction following mastectomy and immediate breast reconstruction: randomized, double-blind, placebo- controlled trial

Arnica montana and Bellis perennis for seroma reduction following mastectomy and immediate breast reconstruction: randomized, double-blind, placebo- controlled trial:

Abstract

Background

Seroma is a common surgical complication created by the inflammatory process that follows mastectomy and reconstruction [9–15]. It is, therefore, common practice to insert surgical drains, which often remain in place for long periods and delay recovery [26, 27]. In light of the many advantages of homeopathic treatment, there has been a global trend of integrating this with conventional medicine [29]. In this study, we examined the effect of Arnica montana and Bellis perennis on seroma prevention after mastectomy and breast reconstruction.

Methods

This was a prospective double-blinded randomized analysis of 55 consecutive patients (78 breasts), who underwent mastectomy and immediate breast reconstruction between January 2016 and August 2017. Patients were randomly assigned and treated with Arnica montana and Bellis perennis or placebo from surgery and up to the time of drain removal.

Results

The mean patient age was 47.9 years. Comorbidities included obesity, diabetes mellitus, essential hypertension, fibromyalgia, and hypothyroidism (1, 4, 6, 2, and 4 patients respectively). Age, body mass index, mastectomy type, and lymph node dissection were similar among groups. Forty-two breasts underwent one-stage procedure, and the remaining were two-stage. Arnica montana and Bellis perennis significantly reduced drain removal time (discharge < 30 ml) by 18% (2.4 days, p < 0.05), 11.1 (6.1) days in the study groups compared with 13.5 (6.4) days in the placebo group. Patient opioid intake was lower (p < 0.057) in the study group. Quality of life, postoperative pain, hemoglobin and cortisol levels, and complications were not associated with any treatment.

Conclusions

Arnica montana and Bellis perennis have been shown to reduce seroma formation and opioid intake following mastectomy and reconstruction. As this treatment lacks side effects and is inexpensive, it should serve as a valuable treatment adjunct in patients undergoing mastectomy and reconstruction.

Level of evidence: Level I, therapeutic study.