Aim: Seroma is the most common complication occurring after breast surgery. Its management usually involves repeated 
aspiration and drain insertion. Tetracycline sclerotherapy appeared successful for treating many chronic fluid collections 
e.g. pleural effusions, hydrocele, liver cysts, renal cysts….etc. The present study aimed to evaluate the efficacy of topical 
tetracycline (TCN) sclerotherapy in treating postmastectomy seroma. 
Methods: Forty nine female patients with resistant post mastectomy seroma were enrolled in the study. All patients 
were subjected to aspiration of the seroma and instillation of 2g tetracycline dissolved in 100 ml sodium chloride 0.9% + 
10 ml Lidocaine. After 24 hours, the solution is re-aspirated and a crepe bandage is applied to the chest wall. Each 
patient is asked to record her pain using the Visual Analogue Scale (VAS). The procedure is repeated in patients who had 
experienced seroma recollection. 
Results: Thirty six patients (73.4%) were successfully treated with one sclerotherapy session while nine patients (18.4%) 
needed two sessions and four patients (8.2%) needed three sessions. The majority of the patients (85.7%) had no 
complications after the technique. 
Conclusion: the topical application of tetracycline is effective and feasible method in the management of refractory post 
mastectomy seroma.