Alyss V Robinson, Howard Peach, Faisal Ali and Donald J Dewar
University of Leeds, United Kingdom
Scientific Tracks Abstracts: Surgery Curr Res
Statement of the Problem: Seromas are a common and unavoidable complication following surgery on a lymph node basin, abdominoplasty and other aesthetic procedures and can pose a threat to successful wound healing. Patients usually present after subsequent infection, requiring prompt intervention and often re-admission. However, there is no consensus as to how to best manage an infected seroma. Methodology and Theoretical Orientation: This retrospective study identified patients with infected seroma following lymphadenectomy for melanoma at a single institution for over 12 years. Details on subsequent readmission were examined, including management, length of inpatient stay, time to discharge from intervention, subsequent complications and follow-up. Findings: Currently, 65 cases of infected seroma have been identified and reviewed. Infected seroma followed SLNB in 26 (40%) cases, CLND in 28 (43%) cases and TLND in 8 (12.3%) cases. Ten (15.4%) cases were managed with intravenous (IV) antibiotics alone, 15 (23%) with ultrasound-guided (US) aspiration and IV antibiotics, 29 (44.6%) with immediate formal incision and drainage with IV antibiotics, and 11 (16.9%) cases underwent a delayed incision and drainage. Immediate formal incision and drainage were associated with a shorter hospital stay compared to IV antibiotics or US-guided aspiration (3 days versus 6 and 5 days respectively), however, this was not statistically significant (p=0.390). Surgical incision and drainage led to a faster discharge (2 days from procedure versus 5 days, p=0.021). Following discharge, patients also required fewer follow-up appointments (mean 2.2 versus 2.9 and 3.1 respectively, p=0.035). However, initial cost analysis indicates a surgical approach is more expensive than a conservative approach (£2,731 versus £1,992), which needs to be assessed further. Conclusion and Significance: More evidence is required, however, there may be meaningful differences in the approaches to managing an infected seroma in terms of efficacy and cost. Once complete, these findings may be applicable to seromas following a number of different reconstructive and aesthetic procedures.
Alyss Vaughan Robinson is a fourth-year undergraduate medical student at The University of Leeds, United Kingdom. She has spent the last three years furthering an interest in Plastic Surgery through a Masters project on biomarkers in malignant melanoma, and with this current cohort study evaluating the management of infected seroma. Robinson has previously presented work both nationally, at the British Association of Plastic Reconstructive and Aesthetic Surgery and Melanoma FOCUS Meetings, and internationally at the International Pigment Cell Conference in Denver, USA and at the 16th Congress of the European Association of Dermato Oncology in Athens, Greece. She aims to continue academic work in both Plastic Surgery and other interests such as Oncology alongside a future career in medicine.
E-mail: um13ar@leeds.ac.uk
