Aetiology of seroma formation in patients undergoing surgery for breast cancer

Surgery for primary breast cancer and regional nodes often involves the use of suction drains post-operatively. It is believed that the fluid accumula ting following axillary surgery is lymph from divided lymphatics or alterna tively serum, although the composition of this fluid has never been studied in detail. Drain fluid following surgery for primary boast cancer was analysed for a n umber of haematological and biochemical parameters. Comparison of these val ues with plasma concentration produced a ratio that was compared with estab lished lymph to plasma ratios. Haematological analysis indicates minimal co ntamination with blood. Comparison of drain fluid to plasma ratios with kno wn lymph to plasma values for biochemical parameters showed that this fluid is compositionally different from lymph, but is similar to inflammatory ex udate. Altering surgical technique to close dead space may avert the need f or wound drainage, lead to reduced hospital stay and reduce the incidence o f 'seroma' formation. (C) 2000 Harcourt Publishers Ltd.