ABSTRACT
Wound seroma is a common early complication after mastectomy. Usually, seroma is painless, but it can cause discomfort and is linked to wound infection, problems with wound healing and lymphedema. Electrocautery has been postulated as a factor in the risk of seroma formation after mastectomy. Sixty-two consecutive mastectomies in 60 patients were randomly assigned to the dissection of the mastectomy flaps with either scalpel [n = 30] or electrocautery [n = 32]. Total volume of fluid output through drains and aspirated seroma was recorded. Other investigated factors included the type of drains utilized, estimated blood loss [EBL] and complications. Seromas were developed in 12 wounds in the electrocautery group compared with four in the scalpel group. Other factors with an independent risk for seroma included the type of drains and lower estimated blood loss. No differences in the characteristics of patients or in other complications were noted. The use of electrocautery to create skin flaps in mastectomy reduced the blood loss, but increased the rate of seroma formation