Proposed Topic (Most preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Proposed Topic (Second preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Authors (including presenting author) :
CHAU PL(1), YAM CLY(2), AU WY(2), MAK YM(2), LEUNG TS(2), YAU LY(2), LEUNG YH(2), WONG MY(2), LAU CM(1), LEUNG WY(1), NG LK(1), LING YH(1)
Affiliation :
(1)Department of Surgery, (2)Occupational Therapy Department, Ruttonjee and Tang Shiu Kin Hospitals
Introduction :
Seroma, accumulation of serous fluid at surgical site, is a common complication following mastectomy. Potential morbidities include delayed wound healing and adjuvant therapy. Multi-disciplinary breast team at Ruttonjee and Tang Shiu Kin Hospitals (RTSKH) has been providing care for breast cancer patients since 2018, including tailor-made compression vests by occupational therapists. Previous evidence, including pilot project conducted by RTSKH breast team in 2019, suggests that compression garments may benefit seroma control.
Enhancements have been made to the vest, including addition of localized padding at time of drain removal (early padding group) or after first seroma aspiration (later padding group). This study aims to investigate the effectiveness of enhanced compression vest in seroma control.
Objectives :
To evaluate the effectiveness of enhanced compression vest in reducing local seroma and aspirations.
Methodology :
Retrospective review was conducted on patients under RTSKH Breast Team between July 2021 and December 2022 after undergoing modified radical mastectomy or simple mastectomy. Patient outcomes within post-operation one month were compared between early padding, later padding and no localized padding group. Outcome measures included local seroma indicated by Total Water Content (TWC) ratio and frequency of aspirations.
Result & Outcome :
60 patients were included, with 19 in early padding group, 8 in later padding group and 33 in no localized padding group.
The enhanced compression vest significantly reduced TWC ratio at peri-axilla area compared to no localized padding group on postoperative day 14 (p=0.037).
Early padding group had significantly lower possibility of requiring aspiration compared to the hypothesized 50% possibility (p=0.004), while later padding group did not show significance.
Conclusion:
The enhanced compression vest has shown potential benefits in early seroma control after mastectomy, particularly in peri-axilla area. Early addition of localized padding at the time of drain removal may reduce the need for aspirations.
Successful enhancement was made possible through precise patient assessment by breast team and individualized tailoring by occupational therapists.
With the promising results, its application has been extended to other case types, including wide local excision and post-mammoplasty hematoma. Further design enhancements and studies on applications in other case types are recommended.
