Factors predicting seroma formation after mastectomy for Chinese breast cancer patients

Loo, Wings T.Y.; Chow, Louis W C

doi:10.4103/0019-509x.38940

Cited by 56 publications

(21 citation statements)

References 3 publications

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“…Only the age of the patient [15] and type of surgery performed [5,16] have been consistently shown to affect the rate of formation of seroma ( Table 2).…”

Section: Discussionmentioning

confidence: 99%

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

Chand¹

2013

ABCR

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Introduction: A 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 breakdown. Infection developing within seroma increases morbidity and often results in the need for re-admission, re-imaging, drainage and antibiotic usage. Numerous methods to reduce post-mastectomy seroma formation have been tried with no consistent success. Methods: 24 consecutive patients undergoing mastectomy and axillary clearance were recruited before and after a departmental change in practice. At the point of skin closure, patients either underwent "axillary exclusion" or not. Total drain outputs were recorded by community district nursing staff for all patients. At the first post-operative visit, the presence and severity of seroma was recorded. Results: 24 patients were included (study group 14, control group 10). Age, size of tumour, and number of positive lymph nodes and laterality were comparable between groups. Mean drain output for the entire group was 471 ml (3 -1030 ml) over 5.21 days. The control group had a drain output of 763.5 ml (95%CI 674.2 -852.8) while the study group had a mean drainage of 262.2 ml (95%CI 161.9 -362.5), a reduction of over 65%, p < 0.001. 15 (62.5%) out of 24 patients developed seroma. 42.9% of the study group and 90% of the control group developed seroma, p < 0.01. Conclusion: Seromas are a common complication following mastectomy and axillary clearance. Our technique of axillary exclusion has resulted in significantly reduced drainage volumes and fewer seromas.

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“…Only the age of the patient [15] and type of surgery performed [5,16] have been consistently shown to affect the rate of formation of seroma ( Table 2).…”

Section: Discussionmentioning

confidence: 99%

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

Chand¹

2013

ABCR

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“…Besides, excessive dissection of axillary lymph nodes and the destruction of more blood vessels and lymphatic vessels might also lead to an increase in postoperative drainage volume 27 . Hypertension has been shown as a significant predictor of drainage duration in many previous studies [6][7][8]10 . The fragility of capillaries and lymphatics were found to be increased in hypertensive patients, causing more postoperative bleeding and wound ooze.…”

Section: Discussionmentioning

confidence: 95%

“…Besides, elastic bandage and external compression dressing were used to obliterate the dead space of the chest wall and axilla after the surgery. The exclusion criteria were as follows: (1) the number of total dissected axillary lymph nodes less than 10, (2) received neoadjuvant therapy before the surgery, (3) distant metastases occurred when patients were diagnosed, (4) drainage duration of axillary suction drain more than 3 weeks, (5) patients with seroma formation after removing axillary suction drain, (6) patients with an incomplete record of drainage duration, (7) patients with a disease that may change hematological data, and (8) patients with other complications. Finally, 972 patients were included in the study.…”

Section: Methodsmentioning

confidence: 99%

“…However, the premature removal of the suction drain may lead to seroma formation, thus increasing the risk of infection, arm lymphedema, and flap necrosis. In addition, later extubation limits postoperative shoulder exercise and prolongs the hospital stay of patients 5 .Hypertension and obesity were recognized as factors that prolong drainage duration in patients undergoing mastectomy and axillary dissection [6][7][8][9][10] . A few other predictors have also been reported, but no model was available for predicting postoperative drainage duration.…”

mentioning

confidence: 99%

“…Hypertension and obesity were recognized as factors that prolong drainage duration in patients undergoing mastectomy and axillary dissection [6][7][8][9][10] . A few other predictors have also been reported, but no model was available for predicting postoperative drainage duration.…”

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confidence: 99%

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Development and validation of a nomogram to predict drainage duration in patients with breast cancer treated with modified radical mastectomy

Xin

Sui

et al. 2021

Sci Rep

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Appropriate drainage duration is vital for the postoperative rehabilitation of patients with breast cancer (BC) undergoing modified radical mastectomy (MRM). To provide better and individualized postoperative management for these patients, this study explored independent predictors of postoperative drainage duration in patients with BC. This was a single-center retrospective cohort study. Patients diagnosed with BC and treated with MRM from May 2016 to April 2020 were randomly divided into training (n = 729) and validation (n = 243) cohorts. Univariate and multivariate Cox analyses revealed that the body mass index, serum albumin level, hypertension, number of total dissected axillary lymph nodes, and ratio of positive axillary lymph nodes were independent predictors of postoperative drainage duration in the training cohort. Based on independent predictors, a nomogram was constructed to predict the median postoperative drainage duration and the probability of retaining the suction drain during this period. This nomogram had good concordance and discrimination both in the training and validation cohorts and could effectively predict the probability of retaining the suction drain during drainage, thus assisting clinicians in predicting postoperative drainage duration and providing individualized postoperative management for patients with BC.

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Quilting following mastectomy reduces seroma, associated complications and health care consumption without impairing patient comfort

Zeelst

Wolde

Eekeren

et al. 2021

Journal of Surgical Oncology

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Background An important complication following mastectomy is seroma formation. Quilting, in which skin flaps are sutured to the underlying muscle, is reported to reduce seroma incidence, but might induce pain and impair shoulder function. Main objective is to compare quilting with conventional wound closure, regarding seroma incidence, health care consumption, and patient discomfort. Methods In a combined prospective and retrospective study, 254 patients undergoing mastectomy and/or axillary lymph node dissection (ALND) were included. Patients received quilting sutures or conventional closure. Primary outcome was clinical significant seroma (CSS). In prospectively included patients shoulder function and analgesic use was observed. Results CSS incidence was 12.9% in the quilted versus 62.3% in the nonquilted cohort (p < 0.001). Surgical site infections were reported significantly less in the quilted cohort. Duration of hospital stay was shorter and outpatient clinic visits were less in the quilted cohort. Surgical procedure required 10 additional minutes for quilting. No significant differences were observed in postoperative shoulder function and analgesic use. Conclusion Quilting following mastectomy reduces CSS incidence. Quilting requires 10 additional minutes during surgery. It facilitates day treatment and results in less additional outpatient clinic visits culminating in reduced health care consumption. Shoulder function and pain are not affected by quilting.

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Factors predicting seroma formation after mastectomy for Chinese breast cancer patients

Cited by 56 publications

References 3 publications

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

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

Development and validation of a nomogram to predict drainage duration in patients with breast cancer treated with modified radical mastectomy

Quilting following mastectomy reduces seroma, associated complications and health care consumption without impairing patient comfort

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