Prevention of seromas in mastectomy wounds. The effect of shoulder immobilization

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)