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Role of quilting technique of mastectomy flap in prevention and reduction of seroma complication in breast cancer patients

Mohend A. N. Al-Shalah

Objective: The aim of study is to evaluate effectiveness of quilting or tacking mastectomy flap in preventing or reducing seroma formation.

Methods: Study included patients with diagnosed breast cancer. Mastectomy with axillary clearance surgery was done for them. Patients were divided according to the technique of closure of mastectomy flap in to quilting and non-quilting group. Primary outcome were the presence of seroma complication and the amount of fluid collection that require aspiration. Secondary outcome were the mean differences of fluid drained, time to remove drain, stage of disease, level of axillary clearance, distribution of patients according to type of malignancy, oestrogen, progesterone and Her2/Neu receptor status.

Results: Results of the study showed that there was a significant association between type of operation and presence of seroma, more seroma occur among patients treated with non-quilting technique (46.8%) in comparison to quilting technique (20%) (P value 0.012) and more time needed to remove drain among patients treated with Non-quilting technique (with mean 5.74 d) in comparison to quilting technique (with mean 4.74 d). There were significant differences between means of amount of aspiration among patients with seroma (n=29) by study groups, more amount of aspiration among patients treated with non-quilting technique (with mean 144.54 ml) in comparison to quilting technique (with mean 60.71 ml).

Conclusion: Quilting or tacking mastectomy flap to the underlying muscles and fascia to obliterate the surgical dead space is effectiveness in prevention and reduction of seroma formation.