Porter K A, O'Connor S, Rimm E, Lopez M
Department of Surgery, St. Elizabeth's Medical Center; and Tufts University School of Medicine, Boston, Massachusetts 02135, USA.
Am J Surg. 1998 Jul;176(1):8-11. doi: 10.1016/s0002-9610(98)00093-2.
Electrocautery has been postulated as a factor in the risk of seroma formation after mastectomy.
Eighty consecutive mastectomies in 74 patients were randomly assigned to dissection of the mastectomy flaps with either scalpel (n = 38) or electrocautery (n = 42). Total volume of fluid output through drains and aspirated from seromas was recorded. Other factors investigated included the type of drain utilized, estimated blood loss, and complications.
Seromas developed in 16 wounds in the electrocautery group compared with 5 in the scalpel group (38% and 13%, respectively; P = 0.01). Other factors with an independent risk for seroma included use of Jackson-Pratt drains compared with Blake drains (P = 0.006), and lower estimated blood loss (P = 0.006). No differences in characteristics of patients or in other complications were noted.
Use of electrocautery to create skin flaps in mastectomy reduced blood loss but increased the rate of seroma formation.
电灼术被认为是乳房切除术后血清肿形成风险的一个因素。
对74例患者连续进行的80例乳房切除术，随机分为用手术刀（n = 38）或电灼术（n = 42）进行乳房切除皮瓣解剖。记录通过引流管引出及从血清肿中抽出的液体总量。研究的其他因素包括所用引流管的类型、估计失血量和并发症。
电灼术组16处伤口发生血清肿，而手术刀组为5处（分别为38%和13%；P = 0.01）。血清肿的其他独立危险因素包括使用杰克逊-普拉特引流管而非布雷克引流管（P = 0.006），以及估计失血量较低（P = 0.006）。患者特征或其他并发症方面未发现差异。
在乳房切除术中用电灼术制作皮瓣可减少失血量，但会增加血清肿形成率。
