ThP1.9 - Seroma in Pre-pectoral Acellular Dermal Matrix-based procedures

Abstract Aims Pre-pectoral reconstruction has gained popularity in recent years and is now considered to be the preferred technique in immediate breast reconstruction. This is done with silicone implants and various synthetic, biological acellular dermal matrix (ADM). Seroma is a well-recognized issue after these IBRs with a wide range of reported incidence (iBAG study). This study reviews incidence and management after Pre-pectoral IBRs with the use of one such porcine ADM (Braxon®). Methods A retrospective audit from a single institution, single surgeon prospectively kept data. The data concerning seroma and its effective management was audited in this study. Results Over an eight-year period, a total of 74 patients with 86 procedures (12 bilateral) were analysed. The mean age was 52.6 and BMI 23.5. Reconstruction was carried out in 89.1% for malignancy, 9.4% had prophylactic surgery and 5.4% had revisions (Subpectoral to Pre-pectoral) for animation. All patients had drains in situ for a mean duration of 7 days. Seroma was seen in 15%(11 patients) of patients but only 18%(2patients) needed intervention in terms of aspiration and/or re-exploration. The authors’ indications for seroma aspiration were based on an algorithm (clinical signs of progression of seroma, skin changes along with signs of poor integration rather than US findings alone) Conclusions From the audit, we could conclude that the formation of seroma is common after ADM and pre-pectoral implant-based IBR but careful monitoring and selective use of aspiration can be practiced thereby minimizing the risk of infection and implant loss as a result of intervention.