Quilting suture is better than conventional suture with drain in preventing seroma formation at pectoral area after mastectomy

Abstract

Background The aim of this study was to compare quilting suture with conventional suture on the formation of seroma at pectoral area after mastectomy (ME) with sentinel lymph nodes biopsy (SLN) or axillary lymph nodes dissection (ALND) for breast cancer. Methods Two hundred thirty-five consecutive breast cancer patients were retrospectively analyzed. The primary outcome was the incidence of Grade 2 or Grade 3 seroma at anterior pectoral area within 1 month postoperatively. We categorized seroma into early or late seroma according to the drainage removal time. Cox regression was used for analysis. Results The incidence of Grade 2 and 3 seroma was significantly higher in the conventional suture group compared with that in the quilting suture group (19.3% vs. 9.5%, p = 0.032), which was attributed to the late seroma in Grade 2 and 3. Quilting suture was associated with longer time for fixing flaps compared with that of conventional suture (504.7 s vs. 109.1 s, p < 0.001), but with less volume of drainage. Old age, high body mass index and conventional suture were independently risk factors for Grade 2 and 3 seroma. Conclusions Quilting suture decreased the incidence of Grade 2 and 3 seroma at pectoral area within 1 month after mastectomy, especially the late seroma in Grade 2 and 3.

Effectiveness of an Adapted Physical Activity Protocol for Upper Extremity Recovery and Quality of Life Improvement in a Case of Seroma after Breast Cancer Treatment

“…Moreover, postoperative radiotherapy can complicate clinical signs and symptoms [3][4][5][6]. Seroma is also considered a frequent side effect of surgery [7][8][9]18].…”

“…Furthermore, another seroma developing area is the peri-prosthetic one [7]. Even if seroma is a common complication during the immediate postoperative period, it is extremely rare as a late complication of breast implant [8,9]. Moreover, clinical findings have shown that a seroma can develop months and years later than surgery [7,8].…”

“…Even if seroma is a common complication during the immediate postoperative period, it is extremely rare as a late complication of breast implant [8,9]. Moreover, clinical findings have shown that a seroma can develop months and years later than surgery [7,8]. Although many seroma patients are asymptomatic, some of them experience persistent pain, shoulder dysfunction, paraesthesia and need persistent fluid aspiration for months.…”

“…Although many seroma patients are asymptomatic, some of them experience persistent pain, shoulder dysfunction, paraesthesia and need persistent fluid aspiration for months. Traumatic aspiration may increase the incidence of surgical site infection, clinic visit, and mental stress of patients [8]. While recent research supports that physical activity (PA) interventions can improve physical functioning, treatment-related symptoms, and QoL in cancer survivors [3,5,10,11], the possible effectiveness of PA in cases developing seroma has yet to be demonstrated [12].…”

<p>The Effect of Low and High Vacuum Drainage on the Postoperative Drainage of Breast Cancer: Insights from a Prospective, Non-Inferiority, Randomized Clinical Trial</p>

“…3 Seroma formation, a fluid collection in the wound, is known as the most common postoperative complication of breast cancer. [4][5][6][7] The reported incidence varies from 20% to 50%, 8 and the closed suction drains were first applied to treat the mastectomy wound to decrease the formation of seroma in 1947, 9 and now are widely used after almost all the breast surgeries. However, there is no well-established consensus or guideline to advise the use of drain.…”