Early Seroma Treatment Protocol Based on US-Guided Aspiration in DTI Prepectoral Reconstruction: A Prospective Study

• Published in: Clinical breast cancer 2023-12, Vol.23 (8), p.e542-e548
• Main Authors: Cazzato, Vito, Scarabosio, Anna, Bottosso, Stefano, Rodda, Agostino, Vita, Ludovica, Renzi, Nadia, Caputo, Glenda, Ramella, Vittorio, Parodi, Pier Camillo, Papa, Giovanni
• Format: Article
• Language: English
• Subjects: ADM breast reconstruction; Breast Implantation - methods; Breast Implants - adverse effects; Breast Neoplasms - complications; Breast surgery; Clinical Protocols; Complications; Female; Humans; Implant-based reconstruction; Mammaplasty - methods; Mastectomy - adverse effects; Mastectomy - methods; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Prospective Studies; Retrospective Studies; Seroma - epidemiology; Seroma - etiology
• ISSN: 1526-8209; 1938-0666
• DOI: 10.1016/j.clbc.2023.09.003

Seroma is a common complication after prepectoral prosthetic breast reconstruction with ADM, leading to wound dehiscencse, infection, and even loss of reconstruction at last. A new ultrasound (US) guided follow-up protocol has been applied to compare primary and secondary complications incidence and their treatment, and evaluate the effect of precocious seroma detection and its evacuation in reducing secondary complications. We enrolled 406 patients from January 1st, 2021 to July 1st, 2023 who underwent mastectomy and 1-stage prepectoral reconstruction with ADM. Experimental group counted 96 patients, whom have been treated as protocol fashion, therefore with multiple US-guided evaluations and eventual evacuations along with postoperative period; control group (310 patients) has exclusively been clinically evaluated. Seroma incidence detected rate among experimental group, after 1-year follow-up, was 32.2%, compared to 16.8% in control cohort, additionally no other secondary complications were detected in the first group. Referring to the wound dehiscence incidence, a statistically significant higher frequency was observed in control group compared with treatment 1 (21.2% vs. 0%; P = .0027). Seroma and correlated secondary complications may lead to additional surgeries, higher sanitary costs and even reconstructive failure. With a seriated US follow-up protocol application, the surgeon could promptly manage and treat seroma, decreasing additional complications rate, particularly wound dehiscence. III. Seroma is a common complication after prepectoral prosthetic breast reconstruction with ADM, leading to wound dehiscence, infection and even loss of implant at last. We enrolled 406 patients who underwent mastectomy and 1-stage prepectoral reconstruction with ADM in which we applied a new US-protocol through which we were able to promptly manage and treat seroma, decreasing additional complications rate, particularly wound dehiscence