Effect of Flap Fixation Technique in Modified Radical Mastectomy on Incidence of Postoperative Seroma Formation

Najeeb, Erum; Rashid, Rakhshanda; Zaffar, Shaista

doi:10.29271/jcpsp.2019.05.410

Cited by 12 publications

(13 citation statements)

References 16 publications

(40 reference statements)

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“…This also agrees with Kontos et al (11) and Schuijtvlot et al (12) . However, this disagrees with Najeeb et al (3) who found that after modified radical mastectomy, there is no substantial reduction in the frequency of seroma development due to flap fixation.…”

Section: Discussionmentioning

confidence: 58%

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Evaluation of The Effect of Mastectomy Flap Fixation and Axillary Space Obliteration with Separation of Both Spaces in Reduction of Seroma Formation in Modified Radical Mastectomy Cases. Ismailia Teaching Oncology Hospital Experience

Ismail¹

2022

The Egyptian Journal of Hospital Medicine

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Background: The most prevalent complication following a modified radical mastectomy (MRM) is seroma located under mastectomy flap and/or axilla, with excessive drainage of serous fluid in the drain, long period of the drain inside the wound with risk of infection. Formation of seroma was diagnosed clinically as collection of fluid under the mastectomy flaps and axilla seen as fluctuant, non-tender swelling. Objective: To study the effect of mastectomy flap fixation and axillary space obliteration with separation of both spaces in comparison with classic modified radical mastectomy in diminishing of seroma formation. Patients and methods: This study included 60 female patients over the age of 20 who were undergoing modified radical mastectomy and were randomly divided into two groups of 30 each, Group A (flap fixation, axillary space obliteration, and two space separation) and Group B (non-flap fixation). Mastectomy flaps were sutured to the underlying pectoralis fascia to obliterate the dead space, with axillary space obliteration by suturing flap into serratus anterior muscle and separation of both spaces along the lateral border of the pectoralis major muscle. Results: There was a statistical significant decrease in day of removing the drain, total seroma volume and frequency of postoperative seroma among Group A (with Flap fixation) compared to Group B (without Flap fixation). There was high statistically significant changes in mean total seroma volume between two group, which ranged (250-1100 cc) in group (A) compared with (1500-3500 cc) in group (B). Conclusion: Dead space obliteration following MRM is a simple technique that lowers the incidence of seroma formation, total seroma volume and days of drain removal.

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Section: Discussionmentioning

confidence: 58%

“…The most prevalent early consequence in MRM patients is seroma formation (2) . Seroma is a sterile clear fluid collection, which developed in the space between the chest wall and skin flaps following MRM (3) .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of The Effect of Mastectomy Flap Fixation and Axillary Space Obliteration with Separation of Both Spaces in Reduction of Seroma Formation in Modified Radical Mastectomy Cases. Ismailia Teaching Oncology Hospital Experience

Ismail¹

2022

The Egyptian Journal of Hospital Medicine

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“…The total study population consisted of 2,956 individuals divided into a study group (SG) that included 1,418 participants (48%) and a control group (CG) that included 1,538 participants (52%). Fifteen studies (Almond et al, 2010; Arafa et al, 2019; Awad et al, 2020; Huang et al, 2021; Khater et al, 2015; Mazouni et al, 2015; Myint et al, 2020; Najeeb et al, 2019; Ouldamer et al, 2015; Sakkary, 2012; ten Wolde et al, 2014; van Bastelaar et al, 2016; van Zeelst et al, 2022; Vettuparambil & Subramanya, 2021; Wu et al, 2020) used quilting sutures as the procedure of choice for flap fixation, three studies used a surgical adhesive (Eichler et al, 2016; Ohlinger et al, 2018; van Bastelaar et al, 2017), and one researcher used both quilting sutures and a surgical adhesive (de Rooij et al, 2021). See Table 1 for detailed information about each of the studies included in the systematic review and meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

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

Soltani

Kargar

Jafari-Nedooshan

et al. 2022

Plastic and Aesthetic Nursing

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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.

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“…The general characteristics of the 8 eligible trials are shown in Table 1 (Ref. [8][9][10][15][16][17][18][19]). For the Granzier, R. W. Y study [10], it involved three groups.…”

Section: Searching Resultsmentioning

confidence: 99%

“…Including flap quilting, several surgical techniques have been used to obliterate the dead space [6]. However, based on the existing data of several trials [7][8][9][10][11][12][13][14][15][16][17][18][19], there are conflicting results in the effectiveness at reducing the incidence of seroma.…”

Section: Introductionmentioning

confidence: 99%

Systematic review and meta-analysis of the use of quilting to prevent seroma formation after mastectomy

Li¹,

Dong²,

Wang³

et al. 2021

European Journal of Gynaecological Oncology

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Objective: Mastectomy is still a rational option for many women with breast cancer. However, the extensive dissection will lead to a large dead space beneath the flap that hampers the adherence to the tissue bed, which increase the seroma rate. Including flap quilting, several surgical techniques have been used to obliterate the dead space. However, there are conflicting results in the effectiveness at reducing the incidence of seroma. This meta-analysis was conducted to better assess the role of the use of quilting in seroma formation after mastectomy. Data sources, methods of study selection: An extensive literature search was performed in the PubMed, Embase and Cochrane databases. Pooled Odds ratio (OR) with 95% confidence intervals (CI) was analyzed. Tabulation, integration and results: A total of 8 trials involving 984 patients were included. Flap quilting showed seroma rate benefit of 20.1% vs 38.4% (OR 0.24, 95% CI 0.10-0.59, p = 0.002). Conclusion: Quilting significantly decreased the seroma rate in patients with breast cancer undergone mastectomy, and flap quilting is a valuable option for patients.

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Effect of Flap Fixation Technique in Modified Radical Mastectomy on Incidence of Postoperative Seroma Formation

Abstract: Objective: To determine the efficacy of flap fixation technique on formation of postoperative seroma after modified radical mastectomy.

Cited by 12 publications

References 16 publications

Evaluation of The Effect of Mastectomy Flap Fixation and Axillary Space Obliteration with Separation of Both Spaces in Reduction of Seroma Formation in Modified Radical Mastectomy Cases. Ismailia Teaching Oncology Hospital Experience

Evaluation of The Effect of Mastectomy Flap Fixation and Axillary Space Obliteration with Separation of Both Spaces in Reduction of Seroma Formation in Modified Radical Mastectomy Cases. Ismailia Teaching Oncology Hospital Experience

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

Systematic review and meta-analysis of the use of quilting to prevent seroma formation after mastectomy

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