PREVENTION OF SEROMA FORMATION AFTER DISSECTION OF MUSCULOCUTANEOUS FLAPS

Dissection of musculocutaneous flaps is uniformly followed by the form ation of seroma if drains are not used. Drains can be colonized and fo rm deep tissue infection if left in place for a long time. In this stu dy we investigated whether talc poudrage could prevent the formation o f seroma following dissection of the latissimus dorsi muscle in a cani ne model. Twelve mongrel dogs were randomized into two groups. Group 1 (n = 6) underwent dissection of the left latissimus dorsi muscle whic h was rotated as a pedicle flap into the left chest through a second i ntercostal space thoracotomy. The wound was closed in layers without d rains. Group 2 (n = 6) had the same procedure, but before closure of t he wound, USP talc was applied to the tissues. All animals received ce fazolin (500 mg) Q8h for 48 hours perioperatively. Animals were follow ed for 1-5 months. Wounds with fluctuation were aspirated as many time s as necessary and the amount of fluid was recorded. All Group 1 anima ls developed seromas, in contrast, only one animal in group 2 had a se roma. There was a significant difference in the amount of fluid aspira ted for each animal between the two groups (280 +/- 80 in group 1 vs 2 5 +/- 25 ml in group 2, P < 0.05). The total amount of fluid drained i n group 1 was 1730 ml, whereas only 150 ml was aspirated in group 2. G roup 1 animals required a total of 11 aspirations to control seromas, in contrast, only one aspiration was needed in group 2. No abscess was identified at postmortem in either group. Based on the results of thi s study we conclude that talc poudrage can be safely used to minimize seroma formation after dissection of musculocutaneous flaps.