| Breast cancer is the second most common cause ofcancer-related death in women. Seroma formation is the mostfrequent postoperative complication after breast cancer surgery.Commonly a seroma large enough to be noticed by the patient ormedical staff and affecting the patient's satisfaction in theimmediate or acute postoperative period and leading tounnecessary costs and complications such as discomfort, infections,and prolongation of hospital stay and new operations. Seromaformation was studied in relation to age, type of surgery, tumor size,nodal involvement, preoperative chemotherapy, surgical instrument(electrocautery or scalpel), use of pressure garment, and duration ofdrainage. Various operative techniques have been studied in aneffort to reduce the volume of postoperative drainage and minimizeseroma formation after the surgical treatment of breast cancer. Anexternal compression dressing after breast cancer surgery woulddecrease postoperative drainage, afford earlier drain removal, andreduce subsequent seroma formation.To compare common thoracic girdle compressed bindingand elastic bandages compressed binding with manual elasticcorset compressed binding in prevention and treatment method ofseroma formation after radical operation of breast cancer.Methods: Between Aug. 2005 and Mar. 2006, 27 women havingsurgery for primary breast cancer at China-Japan Union Hospitalgeneral surgery were randomized to receive either a commonthoracic girdle compressed binding (n=10) , elastic bandagescompressed binding (n=10) or manual elastic corset compressedbinding (n=7) at the completion of the procedure. All patients hadaxillary lymph node dissection as part of the surgical procedure, ofwhom all were available for follow-up with a median of 3.2 months(range1-6). Patients were also stratified for type of surgicalprocedure, specifically, modified radical mastectomy (n=10, 5common thoracic girdle compressed bindings, 3 elastic bandagescompressed bindings, 2 manual elastic corset compressed bindings)or breast radical mastectomy (n=17, 5 common thoracic girdlecompressed bindings, 7 elastic bandages compressed bindings, 5manual elastic corset compressed bindings). In the study, 27patients were divided into three groups: A group (10 patientstreated with common thoracic girdle compressed binding), B group(10 patients treated with elastic bandages compressed binding) andC group (7 patients treated with manual elastic corset compressedbinding). To conduct a retrospective analysis of the seromaformation of the 20 patients treated with common thoracic girdlecompressed binding and elastic bandages compressed binding and7 patients treated with manual elastic corset compressed binding.The efficacy of prevention and treatment method of seromaformation and the complications were compared and analyzed. Of27 patients, The following complications were evaluated at severalpoints: fluidify quantity and duration , the incidence of skin flapnecrosis and limited respiration. Univariate and multivariateanalyses were performed to identify predictors for the measuredsurgical complications.In the study, we have some results. In A group, 4 patients gotsubcutaneous seroma in infraclavicular fossa, 6 patients gotsubcutaneous seroma in axillary, 2 patients got subcutaneousseroma in parasternal region, no patients got subcutaneous seromain inter-rib. In B group, 4 patients got subcutaneous seroma ininfraclavicular fossa, 5 patients got subcutaneous seroma inaxillary, 1 patients got subcutaneous seroma in parasternalregion, 1 patient got subcutaneous seroma in inter-rib. In C group,no patients got subcutaneous seroma in fossa infraclavicular, nopatients got subcutaneous seroma in axillary, 1 patients gotsubcutaneous seroma in parasternal region, no patient gotsubcutaneous seroma in inter-rib. In A group, the amount ofsubcutaneous fluidify was (24.0±6.1) ml. In B group, the amount ofsubcutaneous fluidify was (11.5±4.1) ml. In A group, 1 patients gotchest distress and limited respiration (20%) and no patients got skinflap necrosis (10%). In B group, 7 patients got chest distress and 5patient got skin flap necrosis (50%). In C group, no patients gotchest distress and limited respiration and got no skin flap necrosis.In the present study, there was virtually reduction in fluidifyquantity and duration in patients who were fitted with elasticbandages compressed bindings, compared with those who werefitted with common thoracic girdle compressed binding. Whencomparing the amount of subcutaneous fluidify, the elasticbandages compressed binding group actually had obviously lessthan the common thoracic girdle compressed binding group(P<0.01). When comparing the incidence of skin flap necrosis andlimited respiration, the elastic bandages compressed binding groupactually had obviously more incidence than the common thoracicgirdle compressed binding group (P<0.05). The decreasedincidence of seroma formation in the manual elastic corsetcompressed binding group appears to be the result of decreased theincidence of skin flap necrosis and limited respiration.Therefore, we have drawed the following conclusions. Thefirst, when the patients act, cough or breathe, common thoracicgirdle binding become loose and can not keep on binding. Thesecond, Compared with common thoracic girdle compressedbinding, elastic bandages compressed binding decrease the amountof seroma formation obviously.The third, common thoracic girdlecompressed binding and elastic bandages compressed binding cannot efficiently pressurize in infraclavicular fossa and axillary. Theforth, Compared with common thoracic girdle compressed bindingand elastic bandages compressed binding, Manual elastic corsetcompressed binding pressurize precisely, observe conveniently,regulate partly pressure and is an more ideal method to prevent andtreat seroma formation and skin flap necrosis.This study provides a prospective assessment of the Manualelastic corset compressed binding procedure, as performed by awide range of surgeons, demonstrating a low complication rate.Webelieve it will be used extensively in future.
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