Wound seroma remains a prevalent complication following mastectomy, necessitating the exploration of effective prevention strategies. This study, led by M. Abe, et. al.,(1998) aimed to assess the efficacy of delayed shoulder exercises in mitigating seroma formation after partial or total mastectomy with axillary lymph node dissection for cancer treatment.

A prospective randomized controlled trial was conducted, enrolling a total of 116 participants who underwent mastectomy with axillary lymph node dissection. The cohort was divided into two groups: the immediate exercise group (n = 58), commencing shoulder exercises on the first postoperative day, and the delayed exercise group (n = 58), where upper limb movement was restricted to daily activities during the initial postoperative week.

The delayed exercise group exhibited a noteworthy restoration of preoperative shoulder function levels within one month, despite the one-week delay in initiating shoulder exercises. Furthermore, this group demonstrated a significant reduction in drainage volume and a lower incidence of seroma formation compared to the immediate exercise group.

The findings of this study suggest that delaying shoulder exercises for seven days postoperatively, with a focus on unrestricted movement and avoidance of active shoulder joint exercise, proves to be an optimal routine for minimizing seroma formation after mastectomy. This insight offers a valuable contribution to the development of evidence-based postoperative care strategies, potentially improving patient outcomes and reducing complications associated with mastectomy procedures.

Reference: Abe, M., Iwase, T., Takeuchi, T., Murai, H., & Miura, S. (1998). A randomized controlled trial on the prevention of seroma after partial or total mastectomy and axillary lymph node dissection. Breast cancer, 5, 67-69.