title: Prevention of seroma formation after axillary dissection in breast cancer: a systematic review.
abstract: 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 which 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.
  
  
  CONCLUSIONS
  Seroma formation after breast cancer surgery cannot be avoided at present. There are however several methods to minimize seroma and associated morbidity. Future research should be directed towards the best ways of reducing seroma by combining proven methods.
authors.affiliation: Department of Surgery, Leiden University Medical Centre, The Netherlands. xander2@hotmail.com
authors.forename: A J M
authors.initials: AJ
authors.lastname: van Bemmel
authors.forename: C J H
authors.initials: CJ
authors.lastname: van de Velde
authors.forename: R F
authors.initials: RF
authors.lastname: Schmitz
authors.forename: G J
authors.initials: GJ
authors.lastname: Liefers
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla / Q000601:surgery; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D004322:Drainage / Q000379:methods; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000494:pharmacology; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects* / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008408:Mastectomy / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D018570:Risk Assessment; D049291:Seroma / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive