Axillary node clearance: who wants to immobilize the shoulder?

Sixty-seven patients undergoing level three axillary node clearance were studied to ascertain the benefit of collar and cuff shoulder immobilization in reducing the incidence of axillary seroma formation. During this period the patients' views were obtained on this aspect of post-operative care. Although daily drainage volume decreased more rapidly in those patients whose shoulders were immobilized this did not result in a significant decrease in seroma formation following drain removal on the fifth post-operative day (31% vs 43%, P>0.05). Patient interviews revealed that they found the collar and cuff incapacitating, felt it delayed their return to normal activity and made personal hygiene difficult to maintain. In view of these results shoulder immobilization should not be employed in the routine post-operative care of these patients.