Dissection of
musculocutaneous flaps is uniformly followed by the formation of
seroma if drains are not used. Drains can be colonized and form deep tissue
infection if left in place for a long time. In this study we investigated whether
talc poudrage could prevent the formation of
seroma following dissection of the latissimus dorsi muscle in a canine model. Twelve mongrel dogs were randomized into two groups. Group 1 (n = 6) underwent dissection of the left latissimus dorsi muscle which was rotated as a pedicle flap into the left chest through a second intercostal space
thoracotomy. The
wound was closed in layers without drains. Group 2 (n = 6) had the same procedure, but before closure of the
wound, USP
talc was applied to the tissues. All animals received
cefazolin (500 mg) Q8h for 48 hours perioperatively. Animals were followed for 1-5 months.
Wounds with fluctuation were aspirated as many times as necessary and the amount of fluid was recorded. All Group 1 animals developed
seromas, in contrast, only one animal in group 2 had a
seroma. There was a significant difference in the amount of fluid aspirated for each animal between the two groups (280 +/- 80 in group 1 vs 25 +/- 25 ml in group 2, P < 0.05). The total amount of fluid drained in group 1 was 1730 ml, whereas only 150 ml was aspirated in group 2. Group 1 animals required a total of 11 aspirations to control
seromas, in contrast, only one aspiration was needed in group 2. No
abscess was identified at postmortem in either group. Based on the results of this study we conclude that
talc poudrage can be safely used to minimize
seroma formation after dissection of
musculocutaneous flaps.