Minimizing secondary arm lymphedema from axillary dissection

Regional complications after axillary lymphadenectomy are common and usuall y involve perioperative skin dehiscence, wound infection, and seroma format ion and later arm lymphedema. Gentle handling of tissues during operation, and routine use of closed catheter suction drainage with direct external ax illary compression with immobilization of the shoulder after nodal dissecti on are advocated to minimize both the early and late sequelae. Healing by p rimary intent is facilitated and the opportunity for reconnection of divide d lymphatics (lymphangiogenesis and lymphvasculogenesis) are thereby optimi zed.