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January 1995, Vol 130, No. 1 >
ARTICLE | January 1995

Prevention of Seromas in Mastectomy Wounds: Title and subTitle BreakThe Effect of Shoulder Immobilization FREE

Charles D. Knight, Jr, MD; F. Dean Griffen, MD; Charles D. Knight, Sr, MD
Arch Surg. 1995;130(1):99-101. doi:10.1001/archsurg.1995.01430010101021
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Objective:  To determine if postoperative shoulder immobilization decreases the incidence of postmastectomy seromas.

Design and Setting:  A prospective randomized trial of three surgeons' experiences at a community hospital.

Patients:  Thirty-eight patients who underwent modified radical mastectomy from March 1991 through February 1993.

Main Outcome Measures:  Incidence of postmastectomy seromas and time required for patients to gain 110° of shoulder abduction after surgery.

Results:  Thirteen (72%) of 18 wounds in the maximum range of motion cohort developed seromas (72%) compared with one (6%) of 17 in the minimum range of motion cohort (P=.0005). The average time required for the patients with maximum range of motion to gain 110° of shoulder abduction was 2.6 weeks, whereas the patients with minimum range of motion required an average of 5.0 weeks (P=.0127).

Conclusion:  Postmastectomy shoulder immobilization significantly decreases the incidence of wound seromas. Although this protocol resulted in a delay in return to normal shoulder mobility, no patients sustained longterm musculoskeletal dysfunction.(Arch Surg. 1995;130:99-101)

REFERENCES

1 +
Budd DC, Cochran RC, Sturtz DL, Fouty WJ Jr.  Surgical morbidity after mastectomy operations . Am J Surg . 1978;;135:218-220.
2 +
Guenier C, Coibion M, Badr-elDin A, Nogaret JM, et al.  Morbidity of surgical treatment for advanced cancer of the breast after irradiation . Ann Chir . 1990;; 44:382-385.
3 +
Cohn F Jr. Slack HA, Fisher B.  Complications and toxic manifestations of surgical adjuvant chemotherapy for breast cancer . Surg Gynecol Obstet . 1968;; 127:1201-1209.
4 +
Feigenburg F, Fer M. Dintsman M.  Comparison of postoperative complications following radical and modified radical mastectomy . World J Surg . 1977;;1:207-211.
5 +
Fitts WT, Keuhnelian JG, Ravdin IS, Schor S.  Swelling of the arm after radical mastectomy: a clinical study of its cause . Surgery . 1954;;35:460-464.
6 +
Say CC, Donegan W.  A biostatistical evaluation of complications from mastectomy . Surg Gynecol Obstet . 1974;;138:370-376.
7 +
Clark JA, Kent RB III.  One-day hospitalization following modified radical mastectomy . Am Surg . 1992;;58:239-242.
8 +
Flew TJ.  Wound drainage following radical mastectomy: the effect of restriction of shoulder movement . Br J Surg . 1979;;66:302-305.
9 +
Lotze MT, Duncan MA, Gerber LH, Woltering EA, Rosenberg SA.  Early versus delayed shoulder motion following axillary dissection . Ann Surg . 1980;:193: 288-295.
10 +
Jansen RFM, van Geel AN, de Groot HGW, Rottier AB, Olthuis GAA, van Putten WLJ.  Immediate versus delayed shoulder exercises after axillary lymph node dissection . Am J Surg . 1990;;160:481-484.
11 +
Dawson I, Stam L, Heslinga JM, Kalsbeek HL.  Effect of shoulder immobilization on wound seroma and shoulder dysfunction following modified radical mastectomy: a randomized prospective clinical trial . Br J Surg . 1989;;76:311-312.
12 +
Petrek JA, Peters MM, Nori S, Knauer R, Kinne DW, Rogatko A.  Axillary lymphadenectomy . Arch Surg . 1990;;125:378-382.
13 +
Coons MS, Folliguet TA, Rodriguez C, Woloszyn TT, Tuchler RE, Marini CP.  Prevention of seroma formation after dissection of musculoskeletal flaps . Am Surg . 1993;;59:215-218.
14 +
Aitken R, Hunsaker R, James AG.  Prevention of seromas following mastectomy and axillary dissection . Surg Gynecol Obstet . 1984;;158:327-330.
15 +
Lindsey W, Masterson T, Llaneras M. Spotnitz W, Morgan R.  Seroma prevention using fibrin glue during modified radical neck dissection in a rat model . Am J Surg . 1988;;136:310-313.
16 +
Lindsey W, Masterson T, Spotnitz W, Wilhelm M, Morgan R.  Seroma prevention using fibrin glue in a rat mastectomy model . Arch Surg . 1990;;125:305-307.
17 +
Sitzmann JV, Dufresne C, Zuidema GD.  The use of sclerotherapy for treatment of postmastectomy wound seromas . Surgery . 1983;;93:345-347.

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1 +
Budd DC, Cochran RC, Sturtz DL, Fouty WJ Jr.  Surgical morbidity after mastectomy operations . Am J Surg . 1978;;135:218-220.
2 +
Guenier C, Coibion M, Badr-elDin A, Nogaret JM, et al.  Morbidity of surgical treatment for advanced cancer of the breast after irradiation . Ann Chir . 1990;; 44:382-385.
3 +
Cohn F Jr. Slack HA, Fisher B.  Complications and toxic manifestations of surgical adjuvant chemotherapy for breast cancer . Surg Gynecol Obstet . 1968;; 127:1201-1209.
4 +
Feigenburg F, Fer M. Dintsman M.  Comparison of postoperative complications following radical and modified radical mastectomy . World J Surg . 1977;;1:207-211.
5 +
Fitts WT, Keuhnelian JG, Ravdin IS, Schor S.  Swelling of the arm after radical mastectomy: a clinical study of its cause . Surgery . 1954;;35:460-464.
6 +
Say CC, Donegan W.  A biostatistical evaluation of complications from mastectomy . Surg Gynecol Obstet . 1974;;138:370-376.
7 +
Clark JA, Kent RB III.  One-day hospitalization following modified radical mastectomy . Am Surg . 1992;;58:239-242.
8 +
Flew TJ.  Wound drainage following radical mastectomy: the effect of restriction of shoulder movement . Br J Surg . 1979;;66:302-305.
9 +
Lotze MT, Duncan MA, Gerber LH, Woltering EA, Rosenberg SA.  Early versus delayed shoulder motion following axillary dissection . Ann Surg . 1980;:193: 288-295.
10 +
Jansen RFM, van Geel AN, de Groot HGW, Rottier AB, Olthuis GAA, van Putten WLJ.  Immediate versus delayed shoulder exercises after axillary lymph node dissection . Am J Surg . 1990;;160:481-484.
11 +
Dawson I, Stam L, Heslinga JM, Kalsbeek HL.  Effect of shoulder immobilization on wound seroma and shoulder dysfunction following modified radical mastectomy: a randomized prospective clinical trial . Br J Surg . 1989;;76:311-312.
12 +
Petrek JA, Peters MM, Nori S, Knauer R, Kinne DW, Rogatko A.  Axillary lymphadenectomy . Arch Surg . 1990;;125:378-382.
13 +
Coons MS, Folliguet TA, Rodriguez C, Woloszyn TT, Tuchler RE, Marini CP.  Prevention of seroma formation after dissection of musculoskeletal flaps . Am Surg . 1993;;59:215-218.
14 +
Aitken R, Hunsaker R, James AG.  Prevention of seromas following mastectomy and axillary dissection . Surg Gynecol Obstet . 1984;;158:327-330.
15 +
Lindsey W, Masterson T, Llaneras M. Spotnitz W, Morgan R.  Seroma prevention using fibrin glue during modified radical neck dissection in a rat model . Am J Surg . 1988;;136:310-313.
16 +
Lindsey W, Masterson T, Spotnitz W, Wilhelm M, Morgan R.  Seroma prevention using fibrin glue in a rat mastectomy model . Arch Surg . 1990;;125:305-307.
17 +
Sitzmann JV, Dufresne C, Zuidema GD.  The use of sclerotherapy for treatment of postmastectomy wound seromas . Surgery . 1983;;93:345-347.

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