The composition of serous fluid after axillary dissection

Bonnema, J.; Ligtenstein, David A.; Wiggers, Theo; Geel, A.N. van

doi:10.1080/110241599750007441

Cited by 91 publications

(59 citation statements)

References 20 publications

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“…The closed spaces of quadrantectomy cavities and axillary wounds can harbour seroma. Seroma formation under the skin flaps of axillary wounds impairs the healing process; the skin flaps tend to heal and adhere after 1-3 weeks, as evidenced by diminished drain output [7,15].…”

Section: Discussionmentioning

confidence: 99%

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Does LigaSure(TM) reduce fluid drainage in axillary dissection? A randomised prospective clinical trial

Antonio¹

2015

ecancer

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Background: Axillary lymph node dissection (ALND) is an integral part of breast cancer treatment. It is required in about 40-50% of patients. The placement of a drain in the axilla after an operation is current surgical practice. Short surgical stay programmes increase operating efficiency and reduce medical care costs, without compromising quality of care. LigaSure TM is a new haemostatic device that uses bipolar energy to seal vessels. The aim of this study is to determine whether axillary dissection with LigaSure TM reduces the time of wound drainage, the duration of surgical intervention and the volume of drainage after treatment.

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Section: Discussionmentioning

confidence: 99%

“…The origin of seroma is multi-factorial: it includes lymphorrhea from severed lymphatic vessels, local inflammation, surgically created dead space and use of electrocautery [7][8][9]. Currently accepted surgical practice for the prevention of seromas consists of insertion of a drain during the operation.…”

Section: Introductionmentioning

confidence: 99%

Does LigaSure(TM) reduce fluid drainage in axillary dissection? A randomised prospective clinical trial

Antonio¹

2015

ecancer

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“…6 The dead space created by dissected tissue is filled with serous fluid. 7 This fluid changes composition in the days following surgery. At first it simulates lymph like fluid with blood clots, indicating broken lymph and blood vessels due to the dissection.…”

Section: Pathogenesismentioning

confidence: 99%

Prevention of seroma formation after axillary dissection in breast cancer: A systematic review

Bemmel

Velde

Schmitz

et al. 2011

European Journal of Surgical Oncology (EJSO)

161

133

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Background:The most common complication after breast cancer surgery is seroma formation. It is a source of significant morbidity and discomfort. Many articles have been published describing risk factors and preventive measures. The aim of this paper is to provide a systematic review of studies and reports on risk factors and preventive measures. Surgery lies at the core of seroma formation; therefore focus will be placed on surgical ways of reducing seroma. Methods: A computer assisted medline search was carried out, followed by manual retrieval of relevant articles found in the reference listings of original articles. Results: 136 relevant articles were reviewed. Though the level of evidence remain varied several factors,type of dissection, tools with wich dissection is carried out, reduction of dead space, suction drainage, use of fibrin glue and octreotide usage, have been found to correlate with seroma formation and have been shown to significantly reduce seroma rates. Conclusion: Seroma formation after breast cancer surgery can not be avoided at present. There are however several methods to minimize seroma and associated morbidity. Future research should be directed toward the best ways of reducing seroma by combining proven methods.

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“…[7] Low fibrinogen levels in seromas compared with those in plasma during the postoperative period [8] support the hypothesis that seroma most likely originates from lymph. [9] Seroma formation is influenced by an array of surgical techniques and devices; [10][11][12][13] thus, leading to varying incidence of seroma in different studies.…”

Section: Pathophysiologymentioning

confidence: 99%

Seroma Formation in Cancer Breast Surgery

Sitaram¹,

Hemanthi²

2015

jemds

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Post-operative breast surgery for malignancy has a common side effect of seromas, whose formation and drainage requires a special attention to prevent as much as possible and as early as possible to avoid morbidity. How best we can prevent the dead space is the problem. In this study a review of various methods adopted all over the world is reviewed including early discharge of the patient with drain. It is always preferable to remove the drain when the collection of serum is less than 25ml in 24 hours the chance of re accumulation of fluid is less likely. INTRODUCTION: Carcinoma breast has remained the second leading cause of cancer death among women worldwide over the past three decades [1] and contributes significantly to cancer surgical load. Surgical treatment for breast cancer includes breast conservation therapy and mastectomy with or without axillary dissection depending on disease stage. Seroma formation is the most frequent postoperative Side effect seen after mastectomy and axillary surgery with an incidence of 3% to 85%. OBSERVATIONS: TYPE OF SURGERY: Surgical treatment for breast cancer has undergone a paradigm shift from Halstead's radical mastectomy to breast conservation. It has been demonstrated that radical mastectomy increases seroma formation compared with that of simple mastectomy, but the association is inconclusive when radical mastectomy is compared with modified radical mastectomy (MRM). SURGICAL DEVICES: Various electro-mechanical devices are used during surgery to reduce blood loss and operating time. These include electrocautery, laser scalpel, argon diathermy, ultrasonic scalpel, ultrasonic scissors, and vessel sealing systems. All of these devices have been investigated in an effort to reduce seroma formation. Randomized trials have shown that the use of electrocautery for dissecting flaps is significantly associated with increased seroma formation when compared to that of scalpel dissection. However, no individual study has shown a significant effect on seroma formation with or without the use of a laser scalpel, argon diathermy, or an ultrasonic scalpel. Ultrasonic scissors resulted in reduced seroma formation in a randomized controlled trial comparing level I and II axillary dissection using either ultrasound scissors or surgical scissors with ligation. MANAGEMENT OF DEAD SPACE: MECHANICAL DEVICES: Different techniques have been employed to obliterate the dead space (under flaps and the axilla) to reduce seroma formation. CHEMICAL: Fibrin glue.light activated fibrin sealant, and transdermal photo-polymerized adhesive reduce seroma formation after mastectomy in animal models. Use of a fibrinolysis inhibitor was based on the hypothesis that fibrinolytic activity in serum and lymph might contribute to fluid accumulation. SHOULDER MOVEMENT: Shoulder dysfunction is a common complication of mastectomy,and it is necessary to mobilize the shoulder early to prevent this complication. It was thought that early shoulder mobilization led to increased seroma formation and this hypot...

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The composition of serous fluid after axillary dissection

Cited by 91 publications

References 20 publications

Does LigaSure(TM) reduce fluid drainage in axillary dissection? A randomised prospective clinical trial

Does LigaSure(TM) reduce fluid drainage in axillary dissection? A randomised prospective clinical trial

Prevention of seroma formation after axillary dissection in breast cancer: A systematic review

Seroma Formation in Cancer Breast Surgery

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