Post-mastectomy seroma: a look into etiology and prevention

ABSTRACT

Accumulation of serous fluid in the axillary fossa and under the mastectomy flaps, still remains a common and annoying problem [17% - 63%] after modified radical mastectomy for cancer breast patients. In our study we tried to understand the causes and methods which can reduce or prevent the occurrence of seroma after modified radical mastectomy. One hundred patients with stage II cancer breast randomized into five matched groups were included in this study.The occurrence of seroma was high with the advance of the age, with hypertension, diabetes, obesity and when radial skin incision was used. Shoulder immobilization either alone or with tranexamic acid administration pre and postoperative gave the least incidence of seroma formation [10% and zero respectively] in spite of highest reversible shoulder stiffness [15% and 10% respectively]. Closure of the axillary fossa and fixation of the skin flaps to underlying muscles also, gave good result [15%] but still inferior to shoulder immobilization.The result of use of tranexamic acid alone [20%] and the use of suction drain and compression over skin flaps" traditionally used method "still have a high incidence of postmastectomy seroma [30%]. Post mastectomy seroma rarely causes a serious problem, but can lead to more morbid sequelae as delayed wound healing "thereby delaying further therapy for carcinoma if required ", wound flap necrosis, infection and lymphedema