Fig. 1

Study intra operative images show (a) axillary fossa after mastectomy and axillary clearance and (b) axillary exclusion: the technique was performed by a single surgeon and involved skin flap dissection and the excision of the breast with pectoral fascia, and the dissection of axillary lymph nodes were performed with a diathermy (a). Control of the small bleeding vessels was sustained with coagulate mood of diathermy. Suturing the superior mastectomy skin flap down to the free edge of pectoralis major and the lateral chest wall was done using a continuous 2/0 vicryl stitch, and then, four to six interrupted sutures were placed between pectoralis major and minor to reliably exclude the axillary fossa from the remainder of the mastectomy cavity (b)