Prevention of seroma post-mastectomy by surgical padding technique

Introduction. - Every year, 20,000 mastectomy are realized. The most common complication of these surgical procedure is seroma, occurring in a range of 10 to 85% of the cases, which may be responsible for an increased morbidity by complications: disunity of surgical flap, infection, and delay in administrating adjuvant therapies. Objective. - We focused on a post-mastectomy padding technique, aiming at decreasing incidence of postoperative seromas. Patients and methods. - We conducted a retrospective study of patients treated with mastectomy from January 2012 to March 2014 in Amiens University Hospital. Forty-two patients were included: 20 to the "padding's" group and 22 to the "control's" group. Results. - Drainage flow was significantly decreased at Day 1, Day 2, Day 3 and throughout hospitalization after padding (358.5 mL versus 685 mL; P = 0.02). Hospital stays were significantly shortened by 2 days (5.3 versus 7.3 days; P < 0.05) for patients receiving padding surgery. Discussion and conclusion. Our results show a benefit in the mastectomy padding flap. However, the retrospective character of our study and its strength character imply bias and data not available such as complications in type of wound dehiscence, pain, necrosis, the period from the establishment of the adjuvant therapies and aesthetic evaluation of technique. As such, we initiated a prospective randomized multicenter study late 2013, named PRELYMCA, which should be able to answer the pending questions. (C) 2014 Elsevier Masson SAS. All rights reserved.