Randomised controlled study of seroma rates after mastectomy with and without quilting the skin flap to pectoralis muscle

Abstract

Aims: The aim of this study was to determine whether seroma formation was affected by reduction of the potential dead space with the flap fixation method and obliteration of the axillary region in patients with breast cancer who underwent either mastectomy and axillary lymph node dissection or sentinel lymph node biopsy. A total of 105 patients with breast cancer were divided into two groups according to wound closure patterns. Patients and Methods: The operating time, postoperative pain and complications, time to drain removal, seroma formation, amount of fluid aspirated and number of aspirations were recorded prospectively. Results: No significant difference was found between groups in the rates of seroma development (P = 0.7), complication rates (P = 0.6), time to drain removal (P = 0.5), length of hospital stay (P = 0.3) or numbers of aspiration (P = 0.7). The operating time for fixation was determined to be longer than that of the classic procedure (P = 0.02). Conclusions: Reducing potential dead space with flap fixation and obliteration of the axillary region may be useful in decreasing the development of seroma in patients who have undergone mastectomy because of breast cancer. However, surgical technique must be careful, and appropriate patient follow-up must be conducted.

Quilting Suture Technique After Mastectomy: A Meta-Analysis

“…Table 1 summarizes characteristics of included studies 6,[13][14][15][16][17][18][19][20][21][22][23][24] as well as some surgical technique details. All included 13 studies were RCTs with the level of evidence of 1b or 1c.…”

Seroma formation after mastectomy: A systematic review and network meta‐analysis of different flap fixation techniques

“…In an attempt to improve seroma related outcomes after mastectomy, a considerable amount of research has been performed regarding the prevention of seroma formation and its sequelae. To date, dead space reduction by flap fixation is considered most effective, reducing the incidence of overall seroma by up to 58% when compared to patients who underwent conventional wound closure with drain placement 3–9 . Other methods, such as external compression, shoulder immobilization and the used of surgical adjuncts (e.g., argon diathermy, laser scalpel, and ultrasonic tools) have not been successful 10 …”