A prospective audit of the use of a buttress suture to reduce seroma formation following axillary node dissection without drains.

A prospective audit of seroma formation following breast-conserving surgery for carcinoma with axillary dissection was carried out. Ninety-seven consecutive patients were studied. The post-operative formation of fluid within the axilla (seroma) was recorded on a computerised data collection system. From August 1998 to December 1998, no drain or other axillary restriction was used. The seroma rate in 27 of these patients who had at least seven nodes in the axillary sample was 14/27 (52%). From December 1998 to June 1999, an additional suture was inserted between the axillary skin and the chest wall (buttress suture). This was designed to obliterate the axillary space after dissection. There were 37 patients with seven or more nodes in the axillary dissection in this study and of these, nine patients developed a seroma (24%) (P=0.007). The use of the buttress suture reduces the seroma rate following axillary dissection without axillary drainage.