Axillary Padding as an Alternative to Closed Suction Drain for Ambulatory Axillary Lymphadenectomy

Classe, Jean‐Marc; Dupré, Pierre François; Francois, T.; Robard, S.; Théard, J.-L.; Dravet, F.

doi:10.1001/archsurg.137.2.169

Cited by 68 publications

(48 citation statements)

References 24 publications

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“…Although seroma is considered to consist of lymphatic fluid due to lymphatic vessel damage, its pathophysiology remains poorly understood and controversial (3,5,7). The reported incidence of seroma varies widely between 8 and 81% (8)(9)(10)(11)(12)(13). In our study, we observed a seroma incidence of 22.55% following modified radical mastectomy.…”

Section: Discussionmentioning

confidence: 99%

Potential risk factors for the development of seroma following mastectomy with axillary dissection

Pan

Huan

Qin

2014

Molecular and Clinical Oncology

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Abstract. Seroma is a common complication following breast cancer surgery and the controllable predictive factors remain unknown. Patients who underwent mastectomy with axillary dissection between 2008 and 2011 in our hospital were retrospectively investigated. The demographics, clinical characteristics and therapeutic factors of each patient were recorded. The association of seroma incidence with each variable was evaluated by univariate logistic regression analysis. All the variables were considered independent predictors of seroma incidence. The probability of developing seroma following surgery was evaluated by multivariate logistic regression analysis. A total of 102 patients, with a mean age of 54.86±13.02 years (range, 30-89 years), were included in this study and the incidence of seroma was found to be 22.55%. The operative time (P=0.0066, coefficient = 0.0261, OR=1.03) and the use of patient-controlled intravenous analgesia (PCA) (P=0.0002, coefficient = -1.8089, OR=0.03, ref = no) was significantly associated with the incidence of seroma postoperatively. In conclusion, the prediction of the development of seroma following mastectomy with axillary dissection is challenging. However, a longer operative time and the non-use of PCA may represent potential risk factors for this complication.

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Section: Discussionmentioning

confidence: 99%

Potential risk factors for the development of seroma following mastectomy with axillary dissection

Pan

Huan

Qin

2014

Molecular and Clinical Oncology

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“…Coveney et al [19] showed significantly less drainage in the group of patients where skin flaps were sutured down to the chest wall muscles compared to just conventional skin flap closure. Classe et al [20] showed that axillary padding with the use of axillary aponeurosis alternative to closed suction drain after axillary lymphadenectomy with early discharge. They reported 22.2% seroma rate in 207 of their patients.…”

Section: Wound Closure To Reduce or Obliterate Dead Spacementioning

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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“…In a study from France, Classe and colleagues [34] reported successful use of axillary padding in lieu of catheter drains in 207 patients who had breast cancer undergoing ALND and found seroma formation in 22.2%. In contrast, the Memorial Sloan Kettering Cancer Center conducted a clinical trial that randomly assigned 135 patients undergoing ALND to receive a compression dressing for 4 days or standard wound coverage (all patients had conventional catheter drainage as well).…”

Section: Seromamentioning

confidence: 99%

Complications in Breast Surgery

Vitug

Newman

2007

Surgical Clinics of North America

154

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The breast is a relatively clean organ comprised of skin, fatty tissue, and mammary glandular elements that have no direct connection to any major body cavity or visceral structures. In the absence of concurrent major reconstruction, breast surgery generally is not accompanied by large-scale fluid shifts, infectious complications, or hemorrhage. Thus, most breast operations are categorized as low-morbidity procedures. Because the breast is the site of the most common cancer afflicting American women, however, a variety of complications can occur in association with diagnostic and multidisciplinary management procedures. Some of these complications are related to the breast itself, and others are associated with axillary staging procedures. This article first addresses some general, nonspecific complications (wound infections, seroma formation, hematoma). It then discusses complications that are specific to particular breast-related procedures: lumpectomy (including both diagnostic open biopsy and breast-conservation therapy for cancer), mastectomy; axillary lymph node dissection (ALND), lymphatic mapping/sentinel lymph node biopsy, and reconstruction. Complications related to reconstruction are discussed in a separate article in this issue. General wound complications related to breast and axillary surgeryBecause it is a peripheral soft tissue organ, many wound complications related to breast procedures are relatively minor and frequently are managed on an outpatient basis. It therefore is difficult to establish accurate incidence rates for these events. As discussed later, however, reported studies

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Axillary Padding as an Alternative to Closed Suction Drain for Ambulatory Axillary Lymphadenectomy

Abstract: Hypothesis: Axillary lymphadenectomy performed without the use of a drain but with padding of the axilla is feasible and safe on an outpatient basis in the setting of conservative surgery for breast cancer.

Cited by 68 publications

References 24 publications

Potential risk factors for the development of seroma following mastectomy with axillary dissection

Potential risk factors for the development of seroma following mastectomy with axillary dissection

Seroma Formation after Mastectomy: Pathogenesis and Prevention

Complications in Breast Surgery

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