The pathogenesis of seroma has not been fully elucidated. Seroma
is formed by acute inflammatory exudates in response to surgical
trauma and acute phase of wound healing.10,11 Oertli et al.12
believed that the fibrinolytic activity contributes to seroma formation.
Petrek et al.13 in a prospective randomized trial showed that
the most significant influencing factors in the causation of seroma
were the number and the extent of axillary lymph node involvement.
However, Gonzalez et al.14 and Hashemi et al.15 reported
that the only statistically significant factor influencing the incidence
of seroma formation was the type of surgery. They reported
higher seroma rate in modified radical mastectomy than following
wide local excision and axillary dissection. Factors such as age of
the patient, obesity, tumour size, and neoadjuvant therapy did not
influence the incidence of seroma formation in the three mentioned
studies. Extensive dissection in mastectomy and axillary
lymphadenectomy damages several blood vessels and lymphatics
and the subsequent oozing of blood and lymphatic fluid from
a larger raw surface area when compared with breast-conserving
procedures leads to seroma.16 Seroma accumulation elevates
the flaps from the chest wall and axilla thereby hampering
their adherence to the tissue bed. It thus can lead to significant
morbidity such as wound haematoma, delayed wound healing,
wound infection, flap necrosis, wound dehiscence, prolonged
hospitalization, delayed recovery and initiation of adjuvant
therapy