title: Comparison of incidence of postoperative seroma between flapless and conventional techniques for thyroidectomy: a case-control study.
abstract: OBJECTIVE
  The incidence of seroma after thyroidectomy has been reported between 1.3% and 7%. We hypothesised that a flapless thyroidectomy technique would reduce the incidence of seroma.
  
  
  METHODS
  Observational case-control study with comparison between retrospective cohort of patients undergoing thyroidectomy with raising of conventional skin flaps and prospective cohort undergoing flapless surgery.
  
  
  METHODS
  Academic Teaching Hospital.
  
  
  METHODS
  Hundred and seventy-five consecutive patients undergoing thyroidectomy performed by a single surgeon. After the first 85 cases, a change in practice took place, from raising of conventional skin flaps to performing flapless surgery wherever feasible.
  
  
  METHODS
  Occurrence of postoperative seroma, defined as central neck swelling in postoperative period, confirmed by aspiration of serous fluid, and other complications.
  
  
  RESULTS
  Eight patients who underwent concomitant lateral (jugular) neck dissection were excluded. Among the remaining 167 patients, there were eight seromas (5%). Following the change in practice to flapless surgery, there was a significant reduction in the incidence of seroma (P = 0.025). There was no significant difference in other complications (haematoma; recurrent laryngeal nerve injury; and hypocalcaemia). Among the entire group, the association between seroma and flapless surgery tended towards significance (P = 0.07). Other variables studied, including use of drain and concomitant central compartment neck dissection, had no effect on seroma.
  
  
  CONCLUSIONS
  Flapless technique for thyroid surgery may reduce the incidence of postoperative seroma.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland. sheahan.patrick@sivuh.ie
authors.forename: P
authors.initials: P
authors.lastname: Sheahan
authors.forename: A
authors.initials: A
authors.lastname: O'Connor
authors.forename: M S
authors.initials: MS
authors.lastname: Murphy
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007494:Ireland / Q000453:epidemiology; D011183:Postoperative Complications; D011446:Prospective Studies; D012189:Retrospective Studies; D049291:Seroma / Q000453:epidemiology* / Q000209:etiology; D016038:Skin Transplantation / Q000009:adverse effects* / Q000379:methods; D013524:Surgical Flaps / Q000009:adverse effects*; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods