INNOVATIVE SURGICAL QUILTING: A STRATEGY TO COMBAT SEROMA AFTER MODIFIED RADICAL MASTECTOMY

Abstract

Background: Despite advancements in surgical techniques and postoperative care, seromas continue to be a significant challenge for both patients and healthcare providers following mastectomy. Traditionally, various methods such as surgical drains and compression garments have been employed to manage and mitigate seroma formation. The quilting technique, which involves suturing the mastectomy flap to underlying tissues, has emerged as a promising alternative. This approach aims to obliterate potential spaces where fluid could accumulate, theoretically reducing the incidence of seroma formation.

Material & Methods: Patients were randomly assigned to one of two groups: Group A (Quilting Method) or Group B (Conventional Method) using computer-generated block randomization with concealed allocation. Two weeks post-drain removal, a local examination of the flap and axilla was conducted. In cases where seroma or fluid collection is suspected, a local chest wall ultrasound was  performed to confirm or rule out the presence of seroma. The total volume of drained fluid and occurrences of seroma formation was documented for both groups. The Mann-Whitney test will be utilized to compare the outcomes between the two study groups.

Results: Clinically significant seroma (CSS) was significantly less common in the quilted cohort compared to the non-quilted cohort in both the prospective and combined groups. Specifically, CSS occurred in 2 out of 21 patients (9.5%) in the quilted group, whereas it was observed in 12 out of 21 patients (57.1%) in the non-quilted group (p < 0.001).

Conclusion: The evidence supports effectiveness of Quilting technique in reducing seroma formation and associated complications, including wound infections and prolonged drainage. Studies consistently show that quilting reduces the incidence of seromas and improves overall surgical outcomes.