G. Zoccali, N. Seyidova, R. Price, M. Ho-Asjoe.
Plastic Surgery department, Guy’s and St Thomas' NHS Foundation Trust, London 

Breast reconstruction is now considered to be one of the pillars of breast cancer treatment. Before the introduction of acellular dermal matrix (ADM) there were limitations to the use of implant based reconstruction to which the ADM provides a solution. The use of ADM has increased the number of a single-stage direct to implant breast reconstructions subsequently reducing the number of two-stage reconstructions. Unfortunately however, there are several complications associated with the use of ADM of which seroma is the most frequent. The term seroma is not well defined in the international literature and it is still debatable if it is related to the use of an ADM, at what point we label it as a seroma and how best to manage it. The aim of this short survey is to help find the answers to those questions in order to better define the concept of seroma related to ADM

* 1. Do you use ADM in breast reconstruction?

* 2. Do you use drains with ADM?

* 3. How many drains do you use if an ADM is implanted (no axillary dissection)?

* 4. Do you place the drain to?

* 5. When do you remove the drains?

* 6. Which calibre of drain do you generally use?

* 7. When would you classify a patient having seroma?

* 8. What percentage seroma rate would you estimate you see in your ADM reconstructions?

* 9. How do you manage this complication?

* 10. How do you drain seroma?