An evaluation of post modified radical mastectomy wound and related complications
Keywords:
Breast cancer, Mastectomy, Wound and Related complicationsAbstract
Background: Mastectomy is the resection of part or the whole of the breast with or without axillary dissection to treat or prevent breast cancer. It is the mainstay of loco-regional therapy for operable breast cancer. It may be attended by infective and non-infective post-operative complications.
Aim: To evaluate for wound (surgical site infection, flap necrosis, dehiscence) and other post-operative complications (chronic scar pain, limb lymphoedema, numbness and restricted shoulder movement) of mastectomy in patients with stages I and II breast carcinoma.
Methods: A prospective randomized study in two institutions involving females with histologically diagnosed stages I & II breast cancer undergoing modified radical mastectomy. patients were randomized into two arms; group A had flaps raised with electrocautery while group B had flaps raised with scissors. Wound drains were left in the mastectomy bed and the wound closed primarily. The patients were examined as per the study protocol for specific complications. Shoulder exercises were done pre- and postoperatively. Each patient underwent modified radical mastectomy and randomized to have flaps raised either by electrocautery or scissors. Wounds were drained and closed primarily. The patients were examined weekly over for specific complications.
Results: Forty-six females were studied; 23 in each group. Wound infection (7, 15.2%), dehiscence (4, 8.7%) and flap necrosis (2, 4.3%) were the primary complications. Infection and dehiscence occurred more in the cautery group, 5 (21.7%) and 3(4.3%) respectively. Flap necrosis occurred equally in both groups. One patient developed lymphoedema of the arm. There were no cases of chronic scar pain, numbness or restricted shoulder movement.
Conclusion: Wound infection and dehiscence occur in post-mastectomy patients; their occurrence was more frequent in the group that had flap dissection using cautery compared to scissors.
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