The aim of this study was to compare quilting
suture with axillary drain versus conventional
sutures with axillary and pectoral drain on the formation of
seroma after
modified radical mastectomy with axillary
lymph node dissection. The study was undertaken among 90 female patients with
breast cancer who were candidates for
modified radical mastectomy with axillary clearance. The intervention group (N = 43) with quilting and axillary drain placement and the control group (N = 33) without quilting with axillary and pectoral drain placement. All the patients were followed up for complications pertaining to this procedure. There were no significant differences between the two groups with regard to demographic characteristics, comorbidities, pre-operative
chemotherapy, post-operative pathological findings, lymph node involvement or clinical staging. The incidence of
seroma formation on follow-up was significantly lower in the intervention group than that in the control group (23% versus 58%; p < 0.05) whereas there was no significant difference with respect to flap
necrosis, superficial skin
necrosis and
wound gaping between the two groups. Furthermore, it took a shorter duration for
seroma to resolve in the intervention group (4 days versus 9 days; p < 0.001) with a smaller duration of
hospital stay (4 days versus 9 days; p < 0.001). The use of quilting
sutures for flap fixation in order to obliterate dead space post-
modified radical mastectomy with placement of axillary drain significantly reduced
seroma formation along with shorter duration of
wound drainage and a smaller
hospital stay with only slightly increased
operative time. Therefore, we recommend quilting of flap as a routine step after
mastectomy.