PhD Conferral Mr. drs. James van Bastelaar

“Reducing seroma formation and its sequelae after mastectomy”

Seroma formation (a pocket of fluid) is a common complication after mastectomy for breast cancer and causes patients numerous postoperative problems. Surprisingly, much is still unknown although seroma formation has occurred since the introduction of breast surgery. In order to combat seroma formation, it seems important to reduce dead space by placing vacuum drains and/or flap fixation, i.e. stitching or gluing skin flaps onto the pectoral muscle. This dissertation focussed on flap fixation and showed that this procedure appears to be of great value in terms of seroma formation treatment and avoidance of repeated seroma punctures after mastectomy (with or without axillary lymph node dissection). The prospective double-blinded SAM study (Seroma reduction after ablative breast cancer surgery) showed that flap fixation results in a significant reduction in seroma punctures. An important finding was the apparent absence of adverse side effects of flap fixation. Therefore, flap fixation after mastectomy should be performed in each surgical practice.