ELECTROCAUTERY AS A FACTOR IN SEROMA FORMATION FOLLOWING MASTECTOMY

BACKGROUND: Electrocautery has been postulated as a factor in the risk of seroma formation after mastectomy. METHODS: Eighty consecutive mas tectomies in 74 patients were randomly assigned to dissection of the m astectomy flaps with either scalpel (0 = 38) or electrocautery (0 = 42 ). Total volume of fluid output through drains and aspirated from sero mas was recorded. Other factors investigated included the type of drai n utilized, estimated blood loss, and complications. RESULTS: Seromas developed in 16 wounds in the electrocautery group compared with 5 in the scalpel group (38% and 13%, respectively; P = 0.01). Other factors with an independent risk for seroma included use of Jackson-Pratt dra ins compared with Blake drains (P = 0.006), and lower estimated blood loss (P = 0.006). No differences in characteristics of patients or in other complications were noted. CONCLUSIONS: Use of electrocautery to create skin flaps in mastectomy reduced blood loss but increased the r ate of seroma formation. (C) 1998 by Excerpta Medica, Inc.