Mastectomy using ultrasonic dissection: effect on seroma formation

Seroma formation is the most common complication after mastectomy. Among the several known etiological factors the surgical procedure used may be of importance for seroma formation. This prospective study was carried out to evaluate the ultrasonic energy dissection technique and its effect on seroma formation and other complications: 59 patients with operable breast cancer underwent modified radical mastectomy, performed in 30 of them with an Ultracision Harmonic scalpel and in 29 with scissors and electrocautery. In all cases a standard level II axillary dissection was performed with scissors. We found no differences in the outcome of surgery. Peroperative bleeding (median 300 ml, range 100-790 vs 300 ml, range 40-1400), drain volume (585 ml, range 130-1455) vs 645 ml, range 95-1570), seroma formation 50 (0-580) ml vs 105 (0-3775) ml and wound complications were about the same in both groups. In conclusion, neither clinical advantages or disadvantages of the ultrasound dissection technique were found.