Seroma in Prosthetic Breast Reconstruction.

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Oncology

Background:

• Seroma is a common complication following prosthetic breast reconstruction.
• It can lead to patient distress, aesthetic issues, infection, and prosthesis loss.
• Understanding pathophysiology and risk factors is crucial for effective management.

Purpose of the Study:

• To review the pathophysiology and risk factors of seroma after prosthetic breast reconstruction.
• To collate published practices for seroma avoidance and management.
• To provide current practice guidelines and strategies for prevention and treatment.

Main Methods:

• Systematic literature review of studies published between 2000 and January 2015.
• Databases searched: MEDLINE, Web of Science, Embase, and Cochrane Library.
• Random-effects meta-analysis to estimate pooled incidence and examine risk factors like drain number and acellular dermal matrix use.

Main Results:

• The overall pooled incidence of seroma was 5.4%.
• Identified risk factors include obesity, acellular dermal matrix (pooled relative risk 1.83), and preoperative irradiation.
• Drain practices were collated from 34 articles.

Conclusions:

• Seromas are influenced by the mastectomy skin flap's condition, dead space, and foreign body presence.
• These factors can escalate seroma to infection and prosthesis loss.
• Evidence supports current guidelines and strategies for seroma prevention and treatment.