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Invited Critique
June 16, 2008

Modified Radical Mastectomy With Axillary Dissection Using the Electrothermal Bipolar Vessel Sealing System—Invited Critique

Arch Surg. 2008;143(6):581. doi:10.1001/archsurg.143.6.581

Prolonged axillary drainage and marginal flap necrosis are troubling immediate complications of modified radical mastectomy, and lymphedema is a potentially devastating delayed complication. As surgeons, we compulsively enforce meticulous technique to minimize these complications, and when they occur, we often attribute them to patient and disease variables that are outside of our control. The study by Manouras et al forces us to consider whether readdressing technical factors well within our control could significantly improve outcomes for our patients.