Functional axillary anatomy: time for a new look at the clavipectoral fascia?

King, Burton; Shortis, Amy

doi:10.1111/j.1445-2197.2012.06162.x

Cited by 9 publications

(3 citation statements)

References 9 publications

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“…5 This might not only reduce the seroma formation but also lead to a reduced incidence of lymphedema as well. 28 The endofascial and the routine axillary dissection groups in our study were well matched in terms of patient characteristics. There were no statistically significant differences in terms of age, comorbidities of diabetes and hypertension, and the BMI of the patients.…”

Section: Discussionmentioning

confidence: 99%

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A Prospective Study of the Efficacy of Endofascial Axillary Dissection to Reduce Axillary Seroma Formation

Augustine,

M.,

Bhargavan

et al. 2024

South Asian J Cancer

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Introduction Seroma formation is a common complication following axillary dissection. The pathogenesis of seroma is poorly understood. Various chemical and mechanical methods have been tried to reduce seroma with varying results. In this study, we look at a novel method of axillary dissection to reduce seroma and its attendant morbidity. The objective of the study is to compare endofascial axillary lymphadenectomy with routine axillary lymphadenectomy regarding axillary drain output following breast conservation surgery. Methods We did a prospective interventional study of endofascial axillary dissection in patients undergoing breast conservation surgery. Comparison was done with historical controls who underwent breast conservation surgery with routine axillary lymphadenectomy before the study period. All patients were operated by the same surgeon. Results Breast conservation surgery with endofascial axillary dissection was performed in 36 patients and compared with 36 patients who underwent routine axillary dissection before the study period. The mean total axillary drain output in the endofascial and routine groups were 796.8 and 1,259.3 mL, respectively (p = 0.001). The average day of drain removal in the endofascial and routine groups were 10.8 and 14.9 days, respectively (p = 0.001). The nodal yield of the endofascial and routine groups were 15.3 and 16.4 nodes, respectively (p = 0.449). The duration of surgery of the endofascial and routine groups were 89.3 and 85.1 minutes, respectively (p = 0.366). Conclusion Endofascial axillary dissection significantly reduced the mean total axillary drain output and resulted in early drain removal compared with routine axillary dissection. There were no significant differences in the nodal yield, operative time, seroma aspirations, and wound complications between the endofascial and routine axillary dissection groups.

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Section: Discussionmentioning

confidence: 99%

“…5 This might not only reduce the seroma formation but also lead to a reduced incidence of lymphedema as well. 28…”

Section: Discussionmentioning

confidence: 99%

A Prospective Study of the Efficacy of Endofascial Axillary Dissection to Reduce Axillary Seroma Formation

Augustine,

M.,

Bhargavan

et al. 2024

South Asian J Cancer

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“…We have previously described the laminated, three‐dimensional structure of the CPF that is evident during axillary insonation and dissection . Using this procedure, we have dispensed with axillary drains and only a minority of our patients required axillary seroma aspiration.…”

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confidence: 99%

How to do an endofascial axillary lymphadenectomy

King

Meredith

2014

ANZ J Surg

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The deep fascia and its role in chronic pain and pathological conditions: A review

2022

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The deep fascia is a three‐dimensional continuum of connective tissue surrounding the bones, muscles, nerves and blood vessels throughout our body. Its importance in chronically debilitating conditions has recently been brought to light. This work investigates changes in these tissues in pathological settings. A state‐of‐the‐art review was conducted in PubMed and Google Scholar following a two‐stage process. A first search was performed to identify main types of deep fasciae. A second search was performed to identify studies considering a deep fascia, common pathologies of this deep fascia and the associated alterations in tissue anatomy. We find that five main deep fasciae pathologies are chronic low back pain, chronic neck pain, Dupuytren's disease, plantar fasciitis and iliotibial band syndrome. The corresponding fasciae are respectively the thoracolumbar fascia, the cervical fascia, the palmar fascia, the plantar fascia and the iliotibial tract. Pathological fascia is characterized by increased tissue stiffness along with alterations in myofibroblast activity and the extra‐cellular matrix, both in terms of collagen and Matrix Metalloproteases (MMP) levels. Innervation changes such as increased density and sensitization of nociceptive nerve fibers are observed. Additionally, markers of inflammation such as pro‐inflammatory cytokines and immune cells are documented. Pain originating from the deep fascia likely results from a combination of increased nerve density, sensitization and chronic nociceptive stimulation, whether physical or chemical. The pathological fascia is characterized by changes in innervation, immunology and tissue contracture. Further investigation is required to best benefit both research opportunities and patient care.

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Functional axillary anatomy: time for a new look at the clavipectoral fascia?

Cited by 9 publications

References 9 publications

A Prospective Study of the Efficacy of Endofascial Axillary Dissection to Reduce Axillary Seroma Formation

A Prospective Study of the Efficacy of Endofascial Axillary Dissection to Reduce Axillary Seroma Formation

How to do an endofascial axillary lymphadenectomy

The deep fascia and its role in chronic pain and pathological conditions: A review

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