Reducing Postoperative Seroma by Closing of Axillary Space
Vit Benjasirichai MD*, Akanist Piyapant MD*, Chairat Pokawattana MD*, Jirapong Dowreang MD**
Affiliation : * Department of Surgery, Rajavithi Hospital, Bangkok ** Department of Radiology, Rajavithi Hospital, Bangkok
Background : Seroma is a common complication after mastectomy. Most postoperative seroma occur at the
axilla. Many previous studies had tried to reduce seroma formation after mastectomy by multimodalities.
Closing the dead space gave a good result for many previous retrospective studies but limited number of
randomized control study.
Objective : To reduce postoperative seroma by closing the axillary space as a randomized control study and
to evaluate the incidence of seroma formation at the axilla as a prospective randomized control trial in
axillary space closure by suturing a skin flap to the underlying chest wall after MRM.
Materials and Methods : Total consecutive 16 patients who were diagnosed with breast cancer at Rajavithi
Hospital by pathologic examination from May 2005 to May 2006 and signed informed consent was obtained
in the present study. All patients were randomized after mastectomy before wound closure into the control
group or study group. In the control group, the wound was closed conventionally. In the study group, axillary
space was closed by suturing the skin flap to the underlying muscle, 3 points at mid axillary line. Patients’
characteristics and operative related factors were recorded and compared between the two groups. All
patients received ultrasonographic examination at axilla two weeks after discharge.
Results : There were eight patients in the control group and eight patients in the study group. The patients’
characteristic and tumor characteristics were recorded and compared. There was no statistical significance
of BMI, tumor size, and hormonal status between the two groups. In the study group, the patient’s age was
significantly higher. There was no statistical significance of seroma thickness at the axilla between control
group and study group (1.77 + 1.00 vs. 1.00 + 0.22, p = 0.067).
Conclusion : There was no statistically significant difference of seroma thickness at the axilla between the two
groups. Further study with a larger sample size is required.
Keywords : Closing of axillary space, Seroma, Mastectomy
