Prevention of seromas in mastectomy wounds. The effect of shoulder immobilization
C. D. Knight Jr, F. D. Griffen and Sr. Knight CD
Department of Surgery, Highland Clinic.
OBJECTIVE: To determine if postoperative shoulder immobilization decreases
the incidence of postmastectomy seromas. DESIGN AND SETTING: A prospective
randomized trial of three surgeons' experiences at a community hospital.
PATIENTS: Thirty-eight patients who underwent modified radical mastectomy
from March 1991 through February 1993. MAIN OUTCOME MEASURES: Incidence of
postmastectomy seromas and time required for patients to gain 110 degrees
of shoulder abduction after surgery. RESULTS: 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).
CONCLUSION: 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.
