BACKGROUND
Seroma formation is a common complication of breast and axillary surgery which occurs despite the early use of wound drains. Traditional methods of seroma drainage involve multiple aspirations of 60-ml aliquots dispensed into an adjacent kidney bowl. Detachment of syringe from needle is a potential source of infection and the open expression of syringe contents generates an aerosol of hazardous body fluids.
TECHNIQUE
We describe a safe and convenient closed method of aspiration of wound seromas. The standard 60-ml syringe is connected via a three-way tap to a white (14 gauge) needle. The needle is introduced through the cleaned anaesthetic wound line and seroma contents aspirated until the syringe is full. The tap is turned to the side port to which is attached a 600-ml sealed and calibrated drainage bag (Disposal Depot: Merit Medical UK Ltd, The Atrium Business Centre, North Caldeen Road, Coatbridge, Lanarkshire ML5 4EF, UK). The syringe contents are expelled, the tap rotated and the process repeated until the seroma is aspirated to dryness. The aspirate volume is easily measured, can be sent for microbiological examination or discarded without spillage into standard hospital waste systems.
DISCUSSION
This simple, inexpensive (bag and tap cost about £4.50 each) system allows up to 600 ml of wound seroma to be aspirated into a completely closed system sparing patients and staff the physical and psychological stress of exposure to body fluids. The system reduces the risk of needle displacement and the need for assistance to prevent spillage from the kidney bowl.