Rationale: Seroma formation and its sequelae form the mainstay of complications in breast
cancer surgery. Seroma has an incidence of 3% to 85%. Complications vary from delayed wound
healing, infection, skin flap necrosis, patient discomfort and repeated visits to the out
patient clinic. The key to reducing seroma formations seems to partly lie in the obliteration
of dead space. The use of electrocautery has been demonstrated to increase seroma formation
following mastectomy, however no other surgical devices (laser scalpel, argon diathermy and
ultrasonic scalpel) or substances have proven to be superior in seroma reduction.
No prospective randomized controlled trials have been able to demonstrate which techniques
are superior in reducing seroma and as a consequence patient discomfort in patients
undergoing mastectomy. In a previous retrospective observational study these investigators
demonstrated that mastectomy flap fixation significantly reduced seroma formation and the
number of seroma aspirations. In a pilot study that was recently performed in one of the
investigators hospitals, ARTISS tissue glue was used for skin flap fixation and showed
promising results. The investigators hypothesize that obliteration of the dead space
following mastectomy will significantly reduce seroma formation, its complications and the
discomfort it causes patients undergoing mastectomy.