title: Reducing postoperative seroma by closing of axillary space.
abstract: 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.
  
  
  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 patients 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, Rajavithi Hospital, Bangkok, Thailand.
authors.forename: Vit
authors.initials: V
authors.lastname: Benjasirichai
authors.forename: Akanist
authors.initials: A
authors.lastname: Piyapant
authors.forename: Chairat
authors.initials: C
authors.lastname: Pokawattana
authors.forename: Jirapong
authors.initials: J
authors.lastname: Dowreang
mesh_terms: D001365:Axilla / Q000601:surgery*; D001943:Breast Neoplasms / Q000601:surgery*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008408:Mastectomy / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D012307:Risk Factors; D049291:Seroma / Q000503:physiopathology / Q000517:prevention & control*