A prospective randomised trial of two treatments for wound seroma after breast surgery

Anand, Rajiv; Skinner, Ruby; Dennison, Godwin; Pain, J. A.

doi:10.1053/ejso.2002.1298

Cited by 35 publications

(20 citation statements)

References 12 publications

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“…However, the incidence of seroma formation has been found to be higher when suction drains were used compared with passive drains, whereas some other investigators reported no significant difference correlating to the rate of seroma between the two types of drains [39,40]. In contrast, the incidence of seroma was unacceptably high when suction drain were not used in a study by Kopelman et al [41].…”

Section: Suction Versus Passive Drainagementioning

confidence: 99%

Seroma Formation after Mastectomy: Pathogenesis and Prevention

Sampathraju

Rodrigues

2010

Indian J Surg Oncol

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Post mastectomy seroma remains an unresolved quandary as the risk factors for its formation have still not been identified. Seromas of the axillary space following breast surgery can lead to significant morbidity and delay in the initiation of adjuvant therapy. Various techniques and their modifications have been practiced and published in English literature, but there seems to be no consensus. In this article, all aspects of seroma formation from pathogenesis to prevention including drug therapies have been discussed.

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Section: Suction Versus Passive Drainagementioning

confidence: 99%

Seroma Formation after Mastectomy: Pathogenesis and Prevention

Sampathraju

Rodrigues

2010

Indian J Surg Oncol

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“…Also, there was significant reduction in incidence of seroma favoring the study group by incidence 6.5% (2 patients out of 31) compared to 25% (9 patients out of 36) in control group (P = 0.040), these rates are compatible with previously mentioned ranges by Anand R and Boostrom SY. 6,7 This was accompanied by considerable reduction in the mean amount for drained fluid daily favoring also the study group. We suggest that this happened as normal reflection of cautious preservation of arm lymphatics that can be easily injured or divided during ALND and even if it is injured it could be easily visualized and ligated.…”

Section: Discussionmentioning

confidence: 91%

Role of axillary reverse mapping in decreasing complications after axillary dissection in breast cancer

et al. 2017

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INTRODUCTIONBreast cancer is the most common malignancy in women worldwide and its incidence increases every year.1 From the total female cancer cases in Egypt, breast cancer represented 35.1%. 2The primary site of lymphatic drainage of the breast is the axillary lymph nodes that involved in regional metastatic disease in breast cancer. Axillary lymph node dissection is the standard treatment of axillary lymph node metastasis. It is important for local control, staging and increase the possibility of survival benefit. 3Most of the serious complications after breast surgery are attributed to axillary lymph node dissection such as; lymphedema, seroma and major neurovascular injuries. 4 Seroma is the most common problem occurring after axillary lymph node dissection; excessive fluid accumulation usually stretches the skin and causes it to sag, resulting in patient discomfort, and delay of adjuvant ABSTRACT Background: Breast cancer is one of the most leading causes of cancer deaths in female. Surgical treatment is considered the corner stone in its management. Axillary lymph node dissection (ALND) is an integral step in most of surgeries done, however it has many morbidities like prolonged seroma and lymphedema. Axillary reverse mapping (ARM) procedure was first described in 2007 in a trial to map the axillary lymphatics of the arm and avoid its injury therefore lymph complications. Methods: A prospective, randomized, controlled study over 72 female patients who underwent modified radical mastectomy (MRM). Patients were divided and randomized into study and control groups, thirty-six patients for each. In study group the ARM procedure was done by injecting 2.5 ml of methylen blue dye intra-dermally and subcutaneously in the upper inner ipsilateral arm along the medial intramuscular groove before ALND. Operative and post-operative results were recorded. Follow up was 6 to 24 months. Results: ARM procedure and successful visualization of arm lymphatics was achieved in 31 patients (86.1%). Statistically there was no significant difference between the two groups regarding patient and tumour characteristics, operative time and number of excised L.Ns. There was significant difference favouring the ARM group in decreasing the incidence of seroma (p= 0.040), lymphedema (p= 0.031) and time passed till remove drains (p <0.001). Conclusions: ARM procedure facilitated arm lymphatics visualization. It is easy non-time-consuming procedure. It resulted in significant reduction in incidence of seroma and lymphedema, with considerable reduction in the overall complications rate.

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“…These include closure of dead space [8,9], use of thrombin [10], compression dressings [11,12] aspiration alone instead of drainage [13], use of collagen tissue sealants [14,15], and delaying postoperative shoulder exercises [16]. Use of ultrasonic shears for breast cancer surgery has been described as early as 2000 by Deo et al [17], in which they showed the feasibility of modified radical mastectomy using ultrasonic shears.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonic Shears Versus Electrocautery in Axillary Dissection for Breast Cancer—A Randomized Controlled Trial

Manjunath

Ramesh

Shivakumar

et al. 2014

Indian J Surg Oncol

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Theoretical advantages of use of Ultrasonic shears include less tissue damage and better sealing of lymphatic vessels. This may play a role in reducing prolonged drainage following axillary dissection for breast cancer. We conducted a prospective randomized controlled study to evaluate efficacy of ultrasonic shears over cautery for axillary dissection. Between April 2011 and April 2013, 92 patients were randomized to undergo axillary dissection with either ultrasonic shears (n=46) or electrocautery (n=46). Primary endpoints were time till drain removal and cumulative axillary drainage. Categorical data were compared by Pearson's chi-squared test. Continuous variables were compared by Independent t test or Mann Whitney U test. Data was analyzed using SPSS version 18.0. Both groups were comparable with respect to clinical and pathologic characteristics. Clinical characteristics of mean age, body mass index, side of tumor, neoadjuvant chemotherapy, and type of surgery (breast conservation or mastectomy) were similar. Pathologic variables (weight of specimen, number of lymph nodes harvested, pathologic T and N status, as well as grade of tumor) were also comparable among the two groups. There was no statistically significant difference in either primary endpoint of time till drain removal (15 vs. 14.5 days, p=0.73) or cumulative axillary drainage (1,260 vs. 1,086.5 ml, p=0.79). Patient and disease characteristics among the two groups were similar. But, there was no difference in either primary endpoint of cumulative axillary drainage or time to drain removal. We conclude that there is no advantage to use of ultrasonic shears over cautery in reducing drainage following axillary dissection for breast cancer.

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A prospective randomised trial of two treatments for wound seroma after breast surgery

Cited by 35 publications

References 12 publications

Seroma Formation after Mastectomy: Pathogenesis and Prevention

Seroma Formation after Mastectomy: Pathogenesis and Prevention

Role of axillary reverse mapping in decreasing complications after axillary dissection in breast cancer

Ultrasonic Shears Versus Electrocautery in Axillary Dissection for Breast Cancer—A Randomized Controlled Trial

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