Knight C D, Griffen F D, Knight C D
Department of Surgery, Highland Clinic.
Arch Surg. 1995 Jan;130(1):99-101. doi: 10.1001/archsurg.1995.01430010101021.
To determine if postoperative shoulder immobilization decreases the incidence of postmastectomy seromas.
A prospective randomized trial of three surgeons' experiences at a community hospital.
Thirty-eight patients who underwent modified radical mastectomy from March 1991 through February 1993.
Incidence of postmastectomy seromas and time required for patients to gain 110 degrees of shoulder abduction after surgery.
Thirteen (72%) of 18 wounds in the maximum range of motion cohort developed seromas (72%) compared with one (6%) of 17 in the minimum range of motion cohort (P = .0005). The average time required for the patients with maximum range of motion to gain 110 degrees of shoulder abduction was 2.6 weeks, whereas the patients with minimum range of motion required an average of 5.0 weeks (P = .0127).
Postmastectomy shoulder immobilization significantly decreases the incidence of wound seromas. Although this protocol resulted in a delay in return to normal shoulder mobility, no patients sustained long-term musculoskeletal dysfunction.
确定术后肩部固定是否能降低乳房切除术后血清肿的发生率。
一项针对社区医院三位外科医生经验的前瞻性随机试验。
1991年3月至1993年2月期间接受改良根治性乳房切除术的38名患者。
乳房切除术后血清肿的发生率以及患者术后获得110度肩部外展所需的时间。
最大活动范围组18个伤口中有13个（72%）出现血清肿，而最小活动范围组17个伤口中有1个（6%）出现血清肿（P = .0005）。最大活动范围组患者获得110度肩部外展的平均时间为2.6周，而最小活动范围组患者平均需要5.0周（P = .0127）。
乳房切除术后肩部固定可显著降低伤口血清肿的发生率。虽然该方案导致恢复正常肩部活动延迟，但没有患者出现长期肌肉骨骼功能障碍。
