Axillary “Exclusion”—A Successful Technique for Reducing Seroma Formation after Mastectomy and Axillary Dissection

Chand, Natalie

doi:10.4236/abcr.2013.21.001

Cited by 7 publications

(8 citation statements)

References 6 publications

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“…The incidence of seroma formation in the study group (2%) was significantly less than that in group 2 (14%). Also in the same way with us Chand N, et al at (2012) [22] in their study on a small group (24 patients) found significant reduction (p < 0.01) of drainage volumes and incidence of seroma in the group they had closed off the axillary space from the remainder of the mastectomy cavity they reported an incidence of seroma (62.5%). 90% was in the control group and 42.5% in the study group with a reduction of about 65%.…”

Section: Discussionsupporting

confidence: 68%

“Axillary Space Obliteration”—An Effective Technique in Reducing Seroma Formation after Mastectomy and Axillary Dissection

Elbalshy¹,

Fayed²,

Hagag³

2018

ABCR

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Introduction: Seroma is the commonest complication of breast cancer surgery, and although its consequences most often cause no more than discomfort and anxiety, more important sequelae include flap necrosis and wound dehiscence. Seroma management can be difficult and frustrating for both the patient and surgeon. Numerous methods to reduce post-mastectomy seroma formation have been tried with no consistent success. Methods: Sixty patients were prepared for modified radical mastectomy. Of those, the study group contains 30 patients and the control group contains 30 patients. Study group had axillary space obliteration while the other had the conventional procedure; total drain outputs were recorded daily for all patients prior to drain removal. The drains were removed when the daily drainage was less than 30 ml. Results: This study contains 60 patients, and the study group contains 30 patients, and the control group contains 30 patients. Age, tumor size, No. of positive lymph nodes were of no significant differences to be more concise on the effect of axillary space obliteration. The mean of day of drain removal in the control group was 13.2 ± 1.0 days (9 -18 days) with a mean of total drain output of (4700 ± 90.3 ml) (3722 -4930) while the mean in the study group of day of drain removal was 7.1 ± 1.3 days (6 -12) with a mean of total drain output of 1530 ± 422 ml (range 600 -2100 ml) p < 0.001. Conclusion: Obliteration of axillary space is a valuable procedure that significantly decreases seroma after mastectomy and axillary dissection.

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Section: Discussionsupporting

confidence: 68%

“Axillary Space Obliteration”—An Effective Technique in Reducing Seroma Formation after Mastectomy and Axillary Dissection

Elbalshy¹,

Fayed²,

Hagag³

2018

ABCR

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“…None however have been found to be consistently successful, and consequently, none are used in the common practice. If it is believed that the lymphatics disruption in the axillary fossa are main aetiology, it follows that obliterating this space will minimize fluid collection [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of axillary exclusion on seroma formation after modified radical mastectomy

et al. 2016

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BackgroundBreast cancer represented 35.1 % of total female cancer cases in Egypt. Seroma is one of the most serious and common complications of mastectomy and axillary dissection with incidence between 15 and 81 %. Seroma formation delays wound healing and increases susceptibility to infection, skin flap necrosis, and persistent pain as well as prolonging convalescence. Therefore, several techniques have been investigated to minimize seroma formation with no consistent success. Axillary exclusion is a technique aimed to obliterate dead space after axillary clearance and minimize collection.MethodsSixty-four patients were prepared for modified radical mastectomy. Of those, the study group contains 32 patients and the control group contains 32 patients. Study group had axillary exclusion while the other had the conventional procedure; total drain outputs were recorded daily for all patients prior to drain removal. The drains were removed when the daily drainage was less than 30 ml.ResultsThis study contains 64 patients, the study group contains 32 patients, and the control group contains 32 patients. Age, BMI (mean control = 31.7 and study = 30.2), and tumor size were of no significant differences to be more concise on the effect of axillary exclusion. The mean of day of drain removal in the control group was 17.8 day (15–19) with a mean of total drain output of 4525.6 ml (4430–3660 ml) while the mean in the study group of day of drain removal was 11.3 (10–13) with a mean of total drain output of 1476.2 ml (620–2200 ml), p < 0.00.ConclusionsAxillary exclusion technique is a valuable procedure that significantly decreases seroma postmastectomy and axillary dissection.

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“…Seroma is graded 1 if asymptomatic (only diagnosed by ultrasound), graded 2 if symptomatic but can be managed either medically or by simple aspiration, and graded 3 if symptomatic and requires surgical or radiologic intervention [ 1 ]. The incidence of seroma following mastectomy and axillary clearance varies in reports from 25% to 60% [ 6 ], with even higher incidences being reported [ 1 ]. Despite the extensive investigation [ 7 – 15 ], the exact pathogenesis of postmastectomy seroma is still not fully understood.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Quilting Technique for Reduction of Postmastectomy Seroma: A Randomized Controlled Study

Khater

Elnahas

Roshdy

et al. 2015

International Journal of Breast Cancer

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Background. Postmastectomy seroma causes patients' discomfort, delays starting the adjuvant therapy, and may increase the possibility of surgical site infection. Objective. To evaluate quilting of the mastectomy flaps with obliteration of the axillary space in reducing postmastectomy seroma. Methods. A randomized controlled study was carried out among 120 females who were candidates for mastectomy and axillary clearance. The intervention group (N = 60) with quilting and the control group without quilting. All patients were followed up routinely for immediate and late complications. Results. There were no significant differences between the two groups as regards the demographic characteristics, postoperative pathological finding, and the immediate postoperative complications. The incidence of seroma was significantly lower in the intervention group compared with the control group (20% versus 78.3%, P < 0.001). Additionally, the intervention group had a shorter duration till seroma resolution (9 days versus 11 days, P < 0.001) and a smaller volume of drainage (710 mL versus 1160 mL, P < 0.001) compared with the control group. Conclusion. The use of mastectomy with quilting of flaps and obliteration of the axillary space is an efficient method to significantly reduce the postoperative seroma in addition to significantly reducing the duration and volume of wound drainage. Therefore we recommend quilting of flaps as a routine step at the end of any mastectomy.

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Axillary “Exclusion”—A Successful Technique for Reducing Seroma Formation after Mastectomy and Axillary Dissection

Cited by 7 publications

References 6 publications

“Axillary Space Obliteration”—An Effective Technique in Reducing Seroma Formation after Mastectomy and Axillary Dissection

“Axillary Space Obliteration”—An Effective Technique in Reducing Seroma Formation after Mastectomy and Axillary Dissection

Efficacy of axillary exclusion on seroma formation after modified radical mastectomy

Evaluation of the Quilting Technique for Reduction of Postmastectomy Seroma: A Randomized Controlled Study

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