Mastectomy Flap Quilting Suture Technique with Axillary Drain versus Conventional Suture with Axillary and Pectoral Drain in Reducing Post Modified Radical Mastectomy Seroma Formation

Mastectomy Flap Quilting Suture Technique

Abstract

Background: Seroma after modified radical mastectomy (MRM) is the most common complication, which is reported to cause longer drainage, delayed wound healing, and higher morbidity in the patient. Objective: To compare the mastectomy flap quilting suture technique versus the conventional mastectomy with respect to seroma formation. Methods: This was a prospective randomized controlled trial of 120 female patients with breast carcinoma at stage II-III who were treated at MRM at Allied Hospital, Faisalabad. The patients were randomly divided into two groups: Group A (60 patients) received quilting sutures and an axillary drain, and Group B (60 patients) received conventional closure and dual drains. Seroma was clinically evaluated at 4-week follow-up and analysed using SPSS v25 (p<0.05). Results: Groups were comparable for age (mean 49.85 ± 6.91 vs. 51.5 ± 5.6 years; p = 0.249), tumour size (4.20 ± 0.91 vs. 4.40 ± 0.85 cm; p = 0.209), stage (p = 0.658), and neoadjuvant chemotherapy (p = 0.854). Seroma was significantly lower in Group A (13.3%) versus Group B (28.3%) (p = 0.043). The benefit was most pronounced in Stage II disease (10.9% vs. 27.1%; p = 0.046) and intermediate-sized tumours 3.5–4.4 cm (5.0% vs. 38.5%; p = 0.008). Conclusion: Quilting sutures are an effective method of reducing post-MRM seroma, especially in Stage II disease and intermediate tumour size. Simple, reliable, and cost-effective, this technique should be performed routinely in MRM, particularly in high-risk patients..