Using Drain-Free Flap Fixation Techniques Versus Traditional Wound Closure With Drain Placement to Prevent Seroma Formation and Its Complications in Breast Cancer Patients Undergoing Mastectomy: A Systematic Review and Meta-analysis

Abstract

During the past decade, there has been some controversy related to using flap fixation techniques instead of conventional wound closure methods and drain placement during mastectomy procedures. The purpose of our study was to address this controversy using a systematic review and meta-analysis of current published literature. Nineteen studies met our inclusion criteria. Our sample population consisted of 2,956 participants divided into two groups. The study group (SG) consisted of 1,418 individuals and the control group (CG) consisted of 1,538 participants. We found there was a significant reduction in the incidence of seroma formation (odds ratio [OR] = 0.35; 95% confidence interval, CI [0.3, 0.42]; p < .000) and surgical site infection (OR = 0.65; 95% CI [0.48, 0.88]; p = .006) in the SG compared with the CG. The length of hospital stay was also significantly reduced in the SG (0.59 days; 95% CI [0.73, 0.46]; χ2[6, N = 502] = 52.88; p < .000) compared with the CG. The results of our study show that using a flap fixation technique after mastectomy can decrease the patient's risk for seroma formation and surgical site infection while reducing their length of hospital stay. Further studies with longer follow-up periods are warranted to evaluate long-term complications associated with using a flap fixation technique compared with using conventional wound closure techniques and drain placement.

2022 Plastic and Aesthetic Nursing Journal Award Winners

“…There is a fascinating case report discussing osteonecrosis and osteomyelitis of the proximal third of the tibia that developed in a patient as a late sequela of COVID 19 (Soroa et al, 2022). Mohammed et al (2022) present their findings on the effect of an acupressure training program for pediatric nurses caring for children undergoing chemotherapy and Soltani et al (2022) present their findings of a systematic review and meta-analysis related to preventing seroma formation using drain-free flap fixation techniques compared with using traditional wound closure with drain placement in patients with breast cancer undergoing mastectomy. In part 2 of a two-part series, Guberti (2022) delineates additional strategies for helping medical aesthetics practices have their best year ever.…”

“…There is a fascinating case report discussing osteonecrosis and osteomyelitis of the proximal third of the tibia that developed in a patient as a late sequela of COVID 19 (Soroa et al, 2022). Mohammed et al (2022) present their findings on the effect of an acupressure training program for pediatric nurses caring for children undergoing chemotherapy and Soltani et al (2022) present their findings of a systematic review and…”