Non-infective post-mastectomy complications: A comparison of outcomes of sharp and electrocautery dissection for modified radical mastectomy

Abstract

Objectives Post-mastectomy seroma and haematoma increase morbidity and overall healthcare costs among patients undergoing mastectomy. Electrocautery and scissors are tools frequently used to raise the flap during mastectomy, each having advantages and disadvantages as to forming seroma and haematoma. The present study compared the incidence and volume of post-mastectomy seroma and haematoma following sharp and electrocautery dissection in mobilising flaps. Material and Methods A two-centre prospective, randomised comparative study involving patients with histologically diagnosed breast cancer who underwent mastectomy. Participants were randomly divided into two groups. Group A had electrocautery dissection and haemostasis, while group B had scissors dissection and haemostasis achieved by ligation and pressure packing. Seroma and haematoma formation, including Volume, surgery duration of drainage, and estimated blood loss, were recorded and analysed using SPSS for Windows version 25 (IBM Corp. Armonk, NY). Results The incidence of seroma was 60.9% for group A and 34.8% for Group B, while the mean duration of seroma drainage in Group A was 8.1 ± 0.7 and 6.6 ± 0.7 for Group B (p < 0.001). The mean total volume of seroma drained in group A was 587.9 ± 84.6, while that for Group B was 470.0 ± 75.2 (p = 0.004). The incidence of haematoma formation was 8.7% for group A and 4.3% for Group B (p = 0.550). Conclusion Sharp dissection significantly reduces the volume and duration of seroma drainage.