Comparison between ultrasound-guided aspiration performed using an intravenous cannula or a conventional needle in patients with peri-prosthetic seroma (original) (raw)
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Achieving Reliable Diagnosis in Late Breast Implant Seromas
Plastic and Reconstructive Surgery, 2019
Following the National Comprehensive Cancer Network guidelines, initial workup of an enlarged breast should include the use of ultrasound (US) for the evaluation of fluid collection, breast mass, Disclosure: The author does not have any financial interest in any of the products, devices, or drugs mentioned in this article.
A Clinical Study of Late Seroma in Breast Implantation Surgery
Aesthetic Plastic Surgery, 2012
Background The use of mammary implants may lead to a variety of early and delayed complications. The most common delayed complications are capsular contracture and implant failure. Late seroma has seldom been reported. In a long-term prospective observational study, cases of late seroma were assessed and recorded. Methods Between March 2005 and November 2009, suspected cases of late seroma in patients who had undergone breast augmentation or reconstruction with textured implants were evaluated clinically and with instrumental analyses. An ultrasound-guided needle aspiration of the fluid was performed. Results In this study, 13 cases of late seroma (8 augmentations and 5 reconstructions) were observed. The overall incidence of this complication was 1.68%. Chemical analyses confirmed the diagnosis of seroma, which recurred in all the patients within days of evacuation. For 12 patients, a reoperation was performed, during which the implant was removed, a total capsulectomy was performed, and in cases of subglandular breast augmentation, the implant pocket was changed to a submuscular placement before a new prosthesis was inserted. One patient underwent a second ultrasound-guided needle aspiration. No seroma recurrence was observed in any of the patients during the follow-up period.
Incidence of Clinically Significant Seroma after Breast and Axillary Surgery
Journal of the American College of Surgeons, 2009
Seroma is a collection of serous fluid that occurs at rates ranging from 3% to 85% after breast or axillary surgery. 1,2 Varying methods of defining seroma likely account for the wide variation in rates of incidence reported in the literature. Seromas can interfere with healing, require prolonged treatment, cause patient discomfort, and delay adjuvant treatment. We hypothesized that seromas occur more frequently in extensive surgical procedures or in those that require a drainage tube. In addition, we theorized that seroma and surgical site infection (SSI) were directly correlated. The aims of this study were to evaluate the frequency of seromas that require intervention, to assess variation based on the extent of the breast or axillary surgical procedure, and to evaluate the incidence of SSI in relation to seroma occurrence.
Brachytherapy, 2006
Purpose: To investigate the incidence of, and possible factors associated with, seroma formation after intraoperative placement of the MammoSite catheter for accelerated partial breast irradiation. Methods and Materials: This study evaluated 38 patients who had undergone intraoperative MammoSite catheter placement at lumpectomy or reexcision followed by accelerated partial breast irradiation with 34 Gy in 10 fractions. Data were collected regarding dosimetric parameters, including the volume of tissue enclosed by the 100%, 150%, and 200% isodose shells, dose homogeneity index, and maximal dose at the surface of the applicator. Clinical and treatment-related factors were analyzed, including patient age, patient weight, history of diabetes and smoking, use of reexcision, interval between surgery and radiotherapy, total duration of catheter placement, total excised specimen volume, and presence or absence of postprocedural infection. Seroma was verified by clinical examination, mammography, and/or ultrasonography. Persistent seroma was defined as seroma that was clinically detectable >6 months after radiotherapy completion. Results: After a median follow-up of 17 months, the overall rate of any detectable seroma was 76.3%. Persistent seroma (>6 months) occurred in 26 (68.4%) of 38 patients, of whom 46% experienced at least modest discomfort at some point during follow-up. Of these symptomatic patients, 3 required biopsy or complete cavity excision, revealing squamous metaplasia, foreign body giant cell reaction, fibroblasts, and active collagen deposition. Of the analyzed dosimetric, clinical, and treatment-related variables, only body weight correlated positively with the risk of seroma formation (p ؍ 0.04). Postprocedural infection correlated significantly (p ؍ 0.05) with a reduced risk of seroma formation. Seroma was associated with a suboptimal cosmetic outcome, because excellent scores were achieved in 61.5% of women with seroma compared with 83% without seroma. Conclusion: Intraoperative placement of the MammoSite catheter for accelerated partial breast irradiation is associated with a high rate of clinically detectable seroma that adversely affects the cosmetic outcome. The seroma risk was positively associated with body weight and negatively associated with postprocedural infection.
Techniques in the prevention and management of seromas after breast surgery
Future oncology (London, England), 2014
Seromas are the most frequent complications following breast surgery, resulting in significant discomfort and morbidity with possible delays in commencing adjuvant therapies. Varied clinical practices exist in the techniques employed to prevent and manage seromata. This article assesses published literature on the techniques employed in prevention of seroma formation following breast surgery, evaluating the different methodologies used. Although prevention is the best strategy, seromata remain problematic and we consider their management. The principle findings were that prevention is key to the management of seromata. Methods employed to prevent seromata include suction drainage, shoulder immobilization, quilting sutures, fibrin sealants and innovative measures of managing the axilla, among others. The evidence demonstrated that a combination of quilting and drains significantly reduces the incidence and volumes of seromata. These effects are sustained by minimizing use of electroc...
The Value of Mastectomy Flap Fixation on Seroma Formation after Mastectomy
The Egyptian Journal of Hospital Medicine, 2019
Background: seroma occurs in most patients after mastectomy. It is thought to be caused by the fact that mastectomy leaves a lot of an "empty space" under the skin where the breast tissue used to be. Aim of the work: it was to study the effect of closure of dead space by suture fixation of the mastectomy flaps to the underlying chest wall on the amount and duration of postoperative drainage and seroma formation. Patients and Methods: the current study included 40 female patients with breast carcinoma scheduled for modified radical mastectomy and they were randomized into two groups according to suture fixation of the mastectomy flaps to the underlying chest wa1l. Group I, 20 patients undergone suture fixation of the mastectomy flaps to the underlying chest wa1l raw by raw, closing every potentia1 space. Group II, 20 patients where the wound was c1osed in the conventiona1 method. Results: the flap fixation technique is a valuable procedure that significant1y decrease the in...
Effect Of Flap Fixation On Seroma Formation After Modified Radical Mastectomy
Al-Azhar International Medical Journal
Background: After breast cancer surgery, seroma development is it's the most frequent problem occurs post-operatively. It happens to the majority of women who have undergone a mastectomy. The development of seroma inhibits wound healing, necrosis of skin flap, increases susceptibility to infection and causes chronic pain. Therefore, several ways to promote primary healing and reduce the formation of seroma have been examined. Aim of the study: to investigate the impact of surgically closing dead space on seroma formation and postoperative drainage after mastectomy by suturing the mastectomy flaps to underlying chest wall. Patients and Methods: Thirty women with early-stage breast cancer were scheduled for modified radical mastectomy with axillary lymphadenectomy between January 2021 and July 2021 at Al-Azhar University Hospitals in Cairo, Egypt, in this prospective randomized trial, with a total of 15 people in each group: the study group, and the control group. The two groups were compared using comparative analysis. Results: There was a decreased incidence of seroma formation after flap fixation mastectomy when compared to the control group on both clinical and ultrasonographic levels. Additionally, according to this research, this approach significantly reduces drainage time and fluid drainage. Conclusion: Because of this method's reduced risk of seroma formation, less fluid is drained, and the drains can be removed sooner, making flap fixation a highly beneficial treatment.
Late Seromas after Breast Implants
Plastic and Reconstructive Surgery, 2012
Background: Late seromas surrounding breast implants are becoming an increasingly important issue in breast surgery. The authors report their experience with late seromas and describe their previous management options. Methods: A multicenter retrospective review of patients who developed late seromas (clinically presenting seromas without evidence of overt or documented infection more than 1 year after implant operation) was performed. Management, surgical technique, outcomes, complications, culture findings, and cytology results were recorded. Results: Between 2005 and 2010, 28 late seromas were identified in 25 patients. The average interval from the patient's last surgery to seroma onset was 4.7 years; 27 of 28 breasts (96 percent) had a Biocell textured device in place at the time of seroma development. The late seromas in the series were managed as follows: 15 (53.6 percent) by complete capsulectomy, seroma drainage, and new implant placement; three (10.7 percent) by seroma drainage and new implant placement but without capsulectomy; two (7.1 percent) by complete capsulectomy and seroma drainage but without implant replacement; five (17.9 percent) by only ultrasound-guided seroma drainage without the need for surgical intervention; and three (10.7 percent) by antibiotic therapy alone. All cultures and cytology studies were negative for malignancy or infection; 27 of 28 seromas (96 percent) were treated successfully by one of the described approaches. Conclusions: Biocell textured implants were more likely to be associated with late seromas than were smooth shell implants. The overwhelming majority of late seromas appear to be idiopathic, without clear evidence of infection or malignancy. A graduated approach, including several different management strategies, was used to successfully manage these patients.