O'Dwyer P J, O'Higgins N J, James A G
Department of Surgery, St. Vincent's Hospital, University College Dublin, Ireland.
Surg Gynecol Obstet. 1991 Jan;172(1):55-6.
Seromas are a significant cause of morbidity after modified radical mastectomy. The effect of closing dead space by suturing skin flaps to underlying muscle combined with early removal (48 hours postoperatively) of closed suction drains on formation of the seroma was evaluated prospectively in 37 patients. Thirty-three underwent modified radical mastectomy for invasive carcinoma while four underwent total mastectomy with a level 1 axillary dissection for multifocal intraductal carcinoma. Seromas occurred in three, all were minor, two required one aspiration only and one required two aspirations. Two were seromas of the lower flap while one was an axillary seroma. Except for one patient who had a wound hematoma develop, no other instances of morbidity were noted. Closing dead space by suturing skin flaps to underlying muscle combined with early removal of closed suction drains is associated with a low incidence of seroma formation after mastectomy. Use of this technique has important economic and clinical implications for patients who had mastectomy.
血清肿是改良根治性乳房切除术后发病的一个重要原因。前瞻性评估了37例患者中，通过将皮瓣缝合至下方肌肉来封闭死腔并结合早期（术后48小时）拔除闭式引流管对血清肿形成的影响。33例因浸润性癌接受改良根治性乳房切除术，4例因多灶性导管内癌接受全乳房切除术并进行Ⅰ级腋窝淋巴结清扫术。3例出现血清肿，均为轻度，2例仅需一次抽吸，1例需两次抽吸。2例为下方皮瓣血清肿，1例为腋窝血清肿。除1例出现伤口血肿外，未发现其他发病情况。通过将皮瓣缝合至下方肌肉来封闭死腔并结合早期拔除闭式引流管与乳房切除术后血清肿形成的低发生率相关。该技术的应用对接受乳房切除术的患者具有重要的经济和临床意义。
