Postoperative arm positioning after mastectomy and other procedures in the pectoral region

Mastectomy is the commonest operative procedure in the pectoral region. Other procedures include raising of deltopectoral or pectoralis major myocutaneous flaps. Proper postoperative positioning allowing the least tension on the wound and a primary closure without a skin graft is desirable. An attempt was made to mathematically quantify the effect of various arm positions on skin tensions over the axilla, the chest wall and the cervico-thoracic region. It was found that the position of 90 degrees flexion at the shoulder with 90 degrees flexion of the elbow with the hand pointing across or cephalically, on alternate days, was the most suitable. This position does not compromise movements at the shoulder.