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Prevention of seromas in mastectomy wounds. The effect of shoulder immobilization
C D Knight1, F D Griffen, C D Knight
1Department of Surgery, Highland Clinic.
Objective:
To determine if postoperative shoulder immobilization decreases the incidence of postmastectomy seromas.
Design And Setting:
A prospective randomized trial of three surgeons' experiences at a community hospital.
Patients:
Thirty-eight patients who underwent modified radical mastectomy from March 1991 through February 1993.
Main Outcome Measures:
Incidence of postmastectomy seromas and time required for patients to gain 110 degrees of shoulder abduction after surgery.
Results:
Thirteen (72%) of 18 wounds in the maximum range of motion cohort developed seromas (72%) compared with one (6%) of 17 in the minimum range of motion cohort (P = .0005). The average time required for the patients with maximum range of motion to gain 110 degrees of shoulder abduction was 2.6 weeks, whereas the patients with minimum range of motion required an average of 5.0 weeks (P = .0127).
Conclusion:
Postmastectomy shoulder immobilization significantly decreases the incidence of wound seromas. Although this protocol resulted in a delay in return to normal shoulder mobility, no patients sustained long-term musculoskeletal dysfunction.