Post-mastectomy seroma: Does Dead Space Obliteration Have a Protective Effect?

Murad A Jabir; Abdallah Taha; Mahmoud R Shehata; Mostafa M Sayed; Amer Yehia

Post-mastectomy seroma: Does Dead Space Obliteration Have a Protective Effect?

Murad A Jabir¹^*, Abdallah Taha², Mahmoud R Shehata³, Mostafa M Sayed³ and Amer Yehia⁴: ¹Department of Surgical Oncology, Assuit University, Egypt; ²Department of General Surgery, South Valley University, Egypt; ³Department of General Surgery, Assuit University, Egypt; ⁴Department of General Surgery, Al-azhar assuit University, , Egypt

^*Corresponding Author : Murad A Jabir, Department of Surgical Oncology, Assuit University, Egypt, Tel: +20 127 811 5568, Email: muradjab2010@gmail.com

Received Date: Mar 26, 2017 / Accepted Date: May 04, 2017 / Published Date: May 10, 2017

Abstract

Background: Seroma formation after breast surgery could result in significant morbidity and subsequent delay to commence the adjuvant therapy. A prospective randomized study was done to assess the effect of obliterating the axillary dead space by sutures with Flap fixation after Breast cancer surgery either by Modified Radical Mastectomy (MRM) or Conservative Breast Surgery (CBS) prospectively. In addition, Factors predicting the formation of seroma were analyzed and reported.

Methods: A total of 164 patients diagnosed as Breast cancer, they were randomized to have the post mastectomy dead space obliterated (intervention group) or standard wound closure (control group) following either MRM or CBS. Those had immediate reconstruction were excluded from the study. Drains were routinely left in place until the preceding 48-hour output was < 30 milliliters/day. The duration of the drains left in place and the incidence of seroma formation were reported. A multivariate analysis for the potential factors associated with seroma formation was done.

Results: Fifty-eight (n=58) patients were assigned to the treatment group and 106 (n=106) to the control group. MRM was performed on 105 patients (64%) and CBS on 59 (36%). Ten of the 58 patients (17.2%) in the intervention group developed a seroma in comparison to 33 of the 106 control patients (31.1%) (P=0.03). There was a significant reduction in the duration of suction drain in situ with obliteration of the dead space (P=0.001). No statistically significant differences were observed between intervention and control groups with respect to patient and pathological parameters or the incidence of other wound complications. Multivariate analysis revealed that Significant risk factors for seroma formation were Diabetes Mellitus (DM) (P=0.01), neoadjuvant CTH (P=0.019), number of retrieved L node (P=0.019), and dead space obliteration (P=0.04).

Conclusion: On multivariate analysis, the most significant factors affecting seroma formation were DM, neoadjuvant CTH, number of retrieved L node and Dead Space Obliteration. Dead Space Obliteration following breast cancer surgery is a simple technique that reduces the time of suction tubal drainage, and incidence of seroma formation.

Keywords: Breast cancer; Mastectomy; Dead space; Seroma

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Citation: Jabir MA, Taha A, Shehata MR, Sayed MM, Yehia A (2017) Postmastectomy seroma: Does Dead Space Obliteration Have a Protective Effect?. Breast Can Curr Res 3: 119

Copyright: ©2017 Jabir MA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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