Lymphorrea incidences after modified radical mastectomy with auto cut versus spray mode electro coagulation

e11571 Background: Lymphorrea is one of the most common side effects subsequent to mastectomy. It is a predicting factor for seroma, which are usually painless; however, lymphorrea is also linked to wound infection, wound healing complications and lymphedema. Electrocautery is a significant risk factor for lymphorrea and seroma. Two electrocautery methods—auto cut and spray mode electro coagulation—were compared in this prospective randomized study. Methods: 68 patients with operable breast cancer intended for modified radical mastectomy with axillary lymph node dissection or sentinel node biopsy were randomized into two groups by their date of birth. The patients in the first group were operated by using high frequency coagulation with auto cut, the members of the second group in spray mode. All wounds were drained by two self-regulating suction drainages. The drainages were removed as soon as the drain volume decreased to less than 30 ml/24 hours. Results: The mean drain volume amounted to 276 ml (range 20- 1,200 ml) in the auto cut group and 546 ml (range 100 -1,600ml) in the spray mode group. This difference is highly significant (significance level &lt;0.01, t= -2.9987; p=0.003896). The incidence of seroma formation was 5% in the auto cut group and 23.5% in the spray mode group. Patients who were treated with spray mode electrocautery in average had to be hospitalized two days longer. Conclusions: The lower need for instrument changes makes the spray mode electro coagulation more comfortable for the surgeon. Nonetheless the conventional electrocautery should be preferred to operate radical mastectomy in order to decrease the morbidity risk for patients. No significant financial relationships to disclose. </jats:p