A Comparison of Seroma Formation with and without Quilting of Skin Flaps in Modified Radical Mastectomy
DOI:
https://doi.org/10.70749/ijbr.v3i3.883Keywords:
Seroma Formation, Quilting Technique, Skin Flaps, Modified Radical Mastectomy, Postoperative ComplicationsAbstract
Background: Seroma formation is a common complication following modified radical mastectomy (MRM), often resulting in prolonged recovery and additional interventions. Quilting of skin flaps is a technique proposed to reduce fluid accumulation and improve postoperative outcomes. Objective: This study aims to compare seroma formation rates and other clinical outcomes between patients undergoing MRM with and without quilting of skin flaps. Methods: This randomized controlled trial was conducted at the Department of Surgery, Allama Iqbal Memorial Teaching Hospital, Sialkot from August 2023 to August 2024, with 60 female patients diagnosed with stage II or III breast carcinoma undergoing MRM. The participants were randomly assigned to two groups: Group I (quilted flaps, n=30) and Group II (non-quilted flaps, n=30). Results: Seroma formation occurred in 13.33% of patients in Group I and 63.33% in Group II (p<0.001). The mean drain output was significantly lower in Group I (40 ml/day) compared to Group II (110 ml/day) (p<0.01). Postoperative pain, measured using the VAS, was significantly lower in Group I (mean = 3.5) compared to Group II (mean = 6.8) (p<0.05). Wound healing was more favorable in Group I, with 93.33% showing normal healing by day 14, compared to 73.33% in Group II (p<0.05). The length of hospital stay was shorter in Group I (mean = 4.1 days) compared to Group II (mean = 6.5 days) (p<0.01). Conclusions: It is concluded that quilting of mastectomy flaps significantly reduces seroma formation, postoperative drain output, pain, and promotes better wound healing, leading to a shorter hospital stay.
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Chaudhary, A., & Gautam, S. (2020). A prospective study of factors affecting seroma formation after modified radical mastectomy in patients of carcinoma of breast. International Surgery Journal, 7(9), 2919. https://doi.org/10.18203/2349-2902.isj20203768
NAZ, R., & GONDAL, K. M. Quilting Technique to Prevent Seroma Formation following Mastectomy for Breast Cancer: A Cross-sectional Study.
Najeeb, E., Rashid, R., & Zaffar, S. (2019). Effect of flap fixation technique in modified radical mastectomy on incidence of postoperative Seroma formation. Journal of the College of Physicians and Surgeons Pakistan, 29(5), 410-413. https://doi.org/10.29271/jcpsp.2019.05.410
Ouldamer, L., Caille, A., Giraudeau, B., & Body, G. (2015). Quilting suture of mastectomy dead space compared with conventional closure with drain. Annals of Surgical Oncology, 22(13), 4233-4240. https://doi.org/10.1245/s10434-015-4511-6
Khater, A., Elnahas, W., Roshdy, S., Farouk, O., Senbel, A., Fathi, A., Hamed, E., Abdelkhalek, M., & Ghazy, H. (2015). Evaluation of the quilting technique for reduction of Postmastectomy Seroma: A randomized controlled study. International Journal of Breast Cancer, 2015, 1-6. https://doi.org/10.1155/2015/287398
Ouldamer, L., Bonastre, J., Brunet-Houdard, S., Body, G., Giraudeau, B., & Caille, A. (2016). Dead space closure with quilting suture versus conventional closure with drainage for the prevention of seroma after mastectomy for breast cancer (QUISERMAS): Protocol for a multicentre randomised controlled trial. BMJ Open, 6(4), e009903. https://doi.org/10.1136/bmjopen-2015-009903
Soliman, E. A. H., Shelfa, W. I. M. E., Eltih, O. A. E. A. M., & Ashour, H. R. G. (2022). Incidence of Seroma Formation after using Flap Fixation Technique in Modified Radical Mastectomy. European Journal of Molecular and Clinical Medicine, 9(1), 877+. https://link.gale.com/apps/doc/A698245943/AONE?u=anon~31cfe0d2&sid=googleScholar&xid=3a665159
Yilmaz, S., Aykota, M., Baran, T., Sabir, N., & Erdem, E. (2021). Randomised controlled study of seroma rates after mastectomy with and without quilting the skin flap to pectoralis muscle. Nigerian Journal of Clinical Practice, 24(12), 1779-1784. https://doi.org/10.4103/njcp.njcp_16_21
Aziz, M. (2021). Randomized controlled trial of modified radical mastectomy with and without quilting technique and its effect on Seroma formation. Journal of Surgery & Anesthesia Research, 1-4. https://doi.org/10.47363/jsar/2021(2)122
Yilmaz, S., Aykota, M., Baran, T., Sabir, N., & Erdem, E. (2021). Randomised controlled study of seroma rates after mastectomy with and without quilting the skin flap to pectoralis muscle. Nigerian Journal of Clinical Practice, 24(12), 1779-1784. https://doi.org/10.4103/njcp.njcp_16_21
Wu, Y., Wang, S., Hai, J., Mao, J., Dong, X., & Xiao, Z. (2020). Quilting suture is better than conventional suture with drain in preventing seroma formation at pectoral area after mastectomy. BMC Surgery, 20(1). https://doi.org/10.1186/s12893-020-00725-8
Reddy, A. V., & Mallikarjunappa, S. S. (2017). A randomized controlled trial evaluating the efficacy of mastectomy flap quilting sutures in reducing post modified radical mastectomy seroma formation. International Surgery Journal, 4(2), 714. https://doi.org/10.18203/2349-2902.isj20170219
Chen D, Li Z, Song J, Zheng X, Yu A. Systematic review and meta-analysis of the use of quilting to prevent seroma formation after axillary lymphadenectomy. Int J Clin Exp Med. 2016;9(2):760-72.
Bhagchandani, M., Shukla, V., Maurya, R. K., Chaudhary, A., & Kumar, K. (2023). A comparative study between mastectomy flap quilting sutures with axillary drain versus conventional sutures with axillary and pectoral drain in reducing post-modified radical mastectomy Seroma formation. Indian Journal of Surgery, 85(6), 1384-1389. https://doi.org/10.1007/s12262-023-03756-6
Wu, Y., Wang, S., Hai, J., Mao, J., Dong, X., & Xiao, Z. (2020). Quilting suture is better than conventional suture with drain in preventing seroma formation at pectoral area after mastectomy. BMC Surgery, 20(1). https://doi.org/10.1186/s12893-020-00725-8
De Rooij, L., Van Kuijk, S. M., Granzier, R. W., Hintzen, K. F., Heymans, C., Theunissen, L. L., Von Meyenfeldt, E. M., Van Essen, J. A., Van Haaren, E. R., Janssen, A., Vissers, Y. L., Beets, G. L., & Van Bastelaar, J. (2020). Reducing Seroma formation and its sequelae after mastectomy by closure of the dead space: A multi-center, double-blind randomized controlled trial (SAM-trial). Annals of Surgical Oncology, 28(5), 2599-2608. https://doi.org/10.1245/s10434-020-09225-8
Van Bastelaar, J., Theunissen, L. L., Snoeijs, M. G., Beets, G. L., & Vissers, Y. L. (2017). Flap fixation using tissue glue or sutures appears to reduce Seroma aspiration after mastectomy for breast cancer. Clinical Breast Cancer, 17(4), 316-321. https://doi.org/10.1016/j.clbc.2017.01.005
Meena, S. P., Bishnoi, S., Badkur, M., Lodha, M., Vishnoi, J. R., & Sharma, N. (2024). A quilting sutures technique for flap closure in patients undergoing modified radical mastectomy for the prevention of seroma: A single-center, randomized controlled trial. Journal of Education and Health Promotion, 13(1). https://doi.org/10.4103/jehp.jehp_47_24
Yilmaz, S., Aykota, M., Baran, T., Sabir, N., & Erdem, E. (2021). Randomised controlled study of seroma rates after mastectomy with and without quilting the skin flap to pectoralis muscle. Nigerian Journal of Clinical Practice, 24(12), 1779-1784. https://doi.org/10.4103/njcp.njcp_16_21
Najeeb, E., Rashid, R., & Zaffar, S. (2019). Effect of flap fixation technique in modified radical mastectomy on incidence of postoperative Seroma formation. Journal of the College of Physicians and Surgeons Pakistan, 29(5), 410-413. https://doi.org/10.29271/jcpsp.2019.05.410
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