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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° 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° 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 longterm musculoskeletal dysfunction. (Arch Surg. 1995;130:99-101)

• We report our experience with 1,000 consecutive abdominal wound closures using continuous monofilament polypropylene (Prolene) sutures. Wound dehiscence occurred in four patients (0.4%), and incisional hernia occurred in seven patients (0.7%). The incidence of persistent suture sinus was less than 1%. A comparison of these results with the reported data showed that this method was at least equal to other types of wound closure. While the polypropylene suture is more difficult to handle than traditional sutures, it is probably the preferred suture for contaminated and dirty wounds. It has eliminated the need for retention sutures in our practice, and its use as a continuous, running closure has offered the advantage over the usual interrupted technique of being simpler, faster, and more cost effective. Sepsis has continued to be the greatest cause of failure of abdominal wounds to heal. (Arch Surg1983;118:1305-1308)