Seroma formation related to electrocautery in breast surgery: a prospective randomized trial

Seroma formation is one of the commonest complications following breast cancer surgery. Prospective audit in our unit had identified an increased rate of postoperative seromas, and this seemed to coincide with the introduction of diathermy dissection of the skin flaps. This prospective randomized trial was designed to assess the contribution of diathermy to postoperative seroma formation. Fifty consecutive patients undergoing either wide local excision or mastectomy, with a level 11 axillary clearance, were assigned to either diathermy or scalpel dissection. The incidence of wound seroma was significantly higher in the diathermy group (38% vs 10%, P = 0.03, Fisherʹs exact test). There was no significant difference between groups with respect to age, type of procedure, length of operation, weight of breast specimen or pathological staging. We conclude that diathermy dissection in breast surgery is associated with an increased incidence of seroma formation and cannot be recommended.