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Introduction <p>Despite significant advancement post modified radical mastectomy (MRM) seroma remains inevitable complication. Mostly asymptomatic but repeated aspirations may lead to increased infection, frequent hospital visits, patient stress and financial issues. Quilting is a simple technique to reduce dead space and avoid seroma formation. The present study was designed to compare the incidence of seroma formation between conventional closure and quilting technique.</p> Methodology <p>After taking institutional research review board and ethical committee approval, the present randomized controlled study was done from January 2021 to June 2022. All female Stage I-III breast cancer patients undergoing MRM were included. In study arm, quilting sutures were applied to approximate skin flaps to pectoral muscle at an interval of 2–3&#xa0;cm. The postoperative drain output, hospital stay, seroma rate, drain removal and postoperative surgical complications were recorded and analyzed.</p> Results <p>A total 70 patients (1:1) were recruited. Both the groups were comparable in age, stage, body mass index (BMI), specimen weight, nodal harvest and nodal positivity. The duration of surgery (98.57 ± 12.45&#xa0;min and 110.28 ± 12.30, <i>p</i> &lt; 0.05) was significantly less in conventional group. The postoperative drain output was significantly less on day 2 (134.85 vs. 176.71) and day 5 (223.14&#xa0;ml vs. 283.85&#xa0;ml) in quilting arm. The drain was removed one day earlier in quilting group (<i>p</i> &lt; 0.05). However the incidence of seroma was comparable in both the groups (5.7% in each group). The incidence of surgical site infection and superficial flap necrosis were also very less (5.7% in each) and comparable. There was no difference in postoperative pain score in both the groups.</p> Conclusion <p>The mastectomy flap fixation technique is simple and valuable procedure. The present study shows that it reduces postoperative drain output and facilitates early drain removal; however quilting did not decrease the seroma incidence.</p>

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Quilting Sutures versus Conventional Closure to Prevent Seroma After Modified Radical Mastectomy: A Comparative Study

  • 期刊论文

  • 发表日期：

    2025年6月11日

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  • Ashish Jakhetiya,
  • Darshit Patel,
  • Bhamini Jakhetiya,
  • Ajay Kumar Yadav,
  • Ajay Chauhan,
  • Anjana Verma

摘要

Introduction

Despite significant advancement post modified radical mastectomy (MRM) seroma remains inevitable complication. Mostly asymptomatic but repeated aspirations may lead to increased infection, frequent hospital visits, patient stress and financial issues. Quilting is a simple technique to reduce dead space and avoid seroma formation. The present study was designed to compare the incidence of seroma formation between conventional closure and quilting technique.

Methodology

After taking institutional research review board and ethical committee approval, the present randomized controlled study was done from January 2021 to June 2022. All female Stage I-III breast cancer patients undergoing MRM were included. In study arm, quilting sutures were applied to approximate skin flaps to pectoral muscle at an interval of 2–3 cm. The postoperative drain output, hospital stay, seroma rate, drain removal and postoperative surgical complications were recorded and analyzed.

Results

A total 70 patients (1:1) were recruited. Both the groups were comparable in age, stage, body mass index (BMI), specimen weight, nodal harvest and nodal positivity. The duration of surgery (98.57 ± 12.45 min and 110.28 ± 12.30, p < 0.05) was significantly less in conventional group. The postoperative drain output was significantly less on day 2 (134.85 vs. 176.71) and day 5 (223.14 ml vs. 283.85 ml) in quilting arm. The drain was removed one day earlier in quilting group (p < 0.05). However the incidence of seroma was comparable in both the groups (5.7% in each group). The incidence of surgical site infection and superficial flap necrosis were also very less (5.7% in each) and comparable. There was no difference in postoperative pain score in both the groups.

Conclusion

The mastectomy flap fixation technique is simple and valuable procedure. The present study shows that it reduces postoperative drain output and facilitates early drain removal; however quilting did not decrease the seroma incidence.