The Value of Mastectomy Flap Fixation on Seroma Formation after Mastectomy (original) (raw)
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Effect Of Flap Fixation On Seroma Formation After Modified Radical Mastectomy
Al-Azhar International Medical Journal
Background: After breast cancer surgery, seroma development is it's the most frequent problem occurs post-operatively. It happens to the majority of women who have undergone a mastectomy. The development of seroma inhibits wound healing, necrosis of skin flap, increases susceptibility to infection and causes chronic pain. Therefore, several ways to promote primary healing and reduce the formation of seroma have been examined. Aim of the study: to investigate the impact of surgically closing dead space on seroma formation and postoperative drainage after mastectomy by suturing the mastectomy flaps to underlying chest wall. Patients and Methods: Thirty women with early-stage breast cancer were scheduled for modified radical mastectomy with axillary lymphadenectomy between January 2021 and July 2021 at Al-Azhar University Hospitals in Cairo, Egypt, in this prospective randomized trial, with a total of 15 people in each group: the study group, and the control group. The two groups were compared using comparative analysis. Results: There was a decreased incidence of seroma formation after flap fixation mastectomy when compared to the control group on both clinical and ultrasonographic levels. Additionally, according to this research, this approach significantly reduces drainage time and fluid drainage. Conclusion: Because of this method's reduced risk of seroma formation, less fluid is drained, and the drains can be removed sooner, making flap fixation a highly beneficial treatment.
International Journal of Advanced Research, 2018
Background: Post-operative seroma is a common complication that occurs after modified radical mastectomy, due to accumulation of fluid in the dead space between skin flaps and the underlying chest wall and axilla. The aim of this study is to evaluate the effect of fixation of flaps by suturing to the chest wall muscle on the seroma formation. Patients and Methods: Our prospective study was done in general surgery department, Zagazig University, from Jan 2016 to Nov. 2017. Included 70 female patients with breast cancer operated by modified radical mastectomy, the patients were classified in to two groups (A,B) each group 35 female patients(N=35). Group (A) operated by quilting flap fixation technique while group (B) operated by conventional method. The patients were followed up for one month and both preoperative and postoperative data are recorded, reviewed and statistically analysed for comparison between the two groups. Results: The preoperative results shows nearly similar results between the two groups regarding the age and body mass index .The breast laterality, the comorbidity (diabetes mellitus (DM), hypertension (HTN), anticoagulant drugs) and stages (T,N) shows small difference between the two groups. the post-operative results shows no significant difference in the operative time, number of Infected seroma, Haematoma and Infected wound (P˃0.05).Total amount of drained fluid (ml) ,the duration of drainage (day), Seroma post drain removal and number of seroma needed aspiration all shows significant difference between the two groups (P<0.05). Conclusion: Reduction of the dead space during modified mastectomy by suturing and fixation of the skin flaps to the chest wall is a good technique to decrease post-operative seroma. …………………………………………………………………………………………………….... Introduction:-Breast cancer is considered the second cause of cancer death in women all over the world in the last three decades. 1 Seroma formation is a prevalent complication of breast surgeries, with incidence 3% to 85 % 2 , while pathophysiology of seroma is vague, many factors produce fluid collection after mastectomy 3 , as extensive dissection will lead to large dead space under the flaps, chest wall Irregularity as in deep axillary fossa makes difficulty in flap adherence, chest wall movement during breathing and shoulder movement produce a shearing force which retard adherence of the flaps. 4 Seroma occur secondary to interruption of lymphatic channels which
Polish Journal of Surgery
Introduction: Post-operative seroma formation is one of the most common complications following modified radical mastectomy (MRM). Quilting is a technique where the mastectomy flaps are sutured to the underlying chest wall muscles with sutures, obliterating the dead space. The authors hypothesised that post-mastectomy dead space obliteration by intermittent mastectomy flap fixation leads to decreased drain output and seroma formation. Material and methods: A double-blinded randomised control trial with two arms was conducted from November 2019 to March 2021 in our institute located in India. Patients with non metastatic breast carcinoma planned for MRM were randomly categorised into two groups of 35 patients each. In the test group, each flap was fixed to the underlying muscle using four intermittent 3-0 polyglactin sutures, which was followed by skin closure, and only skin closure was done in the control group. Results: The test and control groups did not differ significantly with ...
Folia Medica Indonesiana, 2021
Highlight: Modification of radical mastectomy with flap fixation treatment in seroma production in breast cancer patients was analyzed.The number of seromas from the drain removal time in patients undergoing modified radical mastectomy with flap fixation was reduced. : Seroma is the most common complication after mastectomy procedure. This study was conducted to analyse the treatment of flap fixation in seroma production after modified radical mastectomy in breast cancer patients. An interventional prospective clinical study in 35 female patients with breast cancer who underwent modified radical mastectomy with flap fixation in the period August-December 2018 and 35 patients without flap fixation through historical data of patient who underwent modified radical mastectomy in the period 2016-2017 at RSUD Dr. Soetomo Surabaya. Data of characteristic patients will be presented descriptively and analyzed statistically using the appropriate test. The result of the statistical test usin...
The Professional Medical Journal
Objective: To compare the effect of flap fixation and non-flap fixation for preventing seroma formation depending upon stage of surgery in patients undergoing mastectomy at RMU Allied Hospitals following mastectomy in our local population. Study Design: Randomized Controlled Trial. Setting: Surgical Units of Holy Family Hospital, Benazir Bhutto Hospital, DHQ Hospital (RMU & Allied Hospital). Period: October 2020 to April 2021. Material & Methods: Sample size of 114 cases was included in the study. It was Non probability, consecutive sampling technique. Patients were equally randomized to flap-fixation (Group A) and non-flap fixation (Group B). Patients of both groups were followed up to 48 hours postoperatively for seroma formation. Results were analysed using SPSS software and compared by applying chi-square test and p-value ≤0.05 considered significant. Results: Statistically significant difference (p-value ≤0.05) for seroma formation was noted only in disease stage IIIA. In group...
Effect of mechanical closure of dead space on seroma formation after Breast surgery
Breast Cancer, 2006
Seroma, a collection of serous fluid, is the most common problem after breast surgery. The aim of this study was to review the effect of mechanical closure of dead space on seroma formation after breast surgery. There are two mechanical methods for closure of the dead space beneath skin flaps: compression by external pressure, and fixation of the flaps with sutures. There is no evidence to suggest that the routine use of a pressure garment or compression dressing is beneficial. However, it appears that suture flap fixation does reduce seroma formation, simplify postoperative care and dressing, and thus allow early removal of drains and discharge. Drains are helpful for mechanical closure of dead space, but in breastconserving surgery this technique may preclude the use of a drain. However, previous studies have often been small in scale and poor in quality. Further studies should examine the effect of this technique on quality of life, cosmesis, and medical economics.
Bali Medical Journal
Introduction: Breast cancer is second cancer in the world and in women, it estimated with 1.67 million new cases of breast cancer in 2012. Breast cancer is often found in the developing and underdeveloped country. Modified Radical Mastectomy (MRM) is one of modality therapy in breast cancer. Seromas is the most often MRM postoperative complications in breast cancer. The ideal skin flap fixation will minimize the discharge of seromas. Method: This research is an experimental research conducted in H. Adam Malik Hospital for one year. The samples were all female patients with breast cancer who went to H. Adam Malik Hospital performed MRM with and without skin flap fixation that meets the inclusion and exclusion criteria. The number of samples was 78 research subjects. The independent Variable is skin flap fixation, and the dependent variable is the production of seroma. Patient characteristic data will be presented descriptively and statistically analyzed using bivariate pairs with the corresponding test. Result: The number of seromas using skin flap fixation is 212.82, and without a skin flap fixation is 357.66 with a value of p = 0.003 (p <0.05). Conclusion: There is a significant difference between the number of seromas in patients who performed modified radical mastectomy (MRM) with and without skin flap fixation.
A prospective randomised trial of two treatments for wound seroma after breast surgery
European Journal of Surgical Oncology (EJSO), 2002
Aims: Seroma formation is a recognised complication of breast surgery causing wound pain and discomfort. It was hypothesised that daily aspiration of symptomatic seromas that formed after breast surgery would encourage flap adherence to the chest wall, thereby allowing swifter resolution of seroma. Methods: Thirty-six patients undergoing mastectomy and/or axillary clearance who formed seroma post operatively, were randomised into two groups either having daily aspiration of seroma or aspiration as required by patient symptoms. Results: The daily aspiration required significantly more attendances for aspiration (P , 0.005) and the time from surgery to final aspiration was not reduced. Conclusion: Daily aspiration of symptomatic seroma did not result in swifter resolution.
An Overview of Post Mastectomy Seroma and Treatment Options: Review Article
The Egyptian Journal of Hospital Medicine, 2022
Background: Among women, breast cancer is the most common kind of diagnosis, the main cause of cancer-related death, and the leading source of lost life years due to disability-adjusted for global mortality. Breast-conserving surgery or mastectomy is common in the treatment of the disease which was relied on for many years. Seroma is a common side effect after mastectomy. Some surgeons view it as a necessary evil that must be endured after surgery. Seroma formation following breast surgery can occur anywhere from 3% to 85% of the time. Objective: This review aims to give an overview of seroma formation after mastectomy surgeries and the possible treatment options. Methods: The databases were searched for articles published on 3 databases [PubMed-Google scholar-science direct] and Boolean operators (and, or, not) had been used such as [Post Mastectomy Seroma, Breast cancer surgery and Treatment for breast cancer] and in peer-reviewed articles between January 2009 and June 2021. Conclusion: Although post-mastectomy seroma occurs in the vast majority of individuals, tightening the flap after surgery may help avoid its development.
ANZ Journal of Surgery, 2020
Background: Total mastectomy and axillary dissection is a common procedure for breast cancer patients in our institution. Seroma is common. This study aimed to compare the quilting suture and conventional closure in prevention of seroma after total mastectomy and axillary dissection. Methods: This randomized comparative study was carried out from January 2018 to June 2019 in Yangon General Hospital. One hundred and forty patients (70 conventional and 70 quilting) were included. For quilting group, customized strategically placed interrupted alternate sutures were placed 2-3 cm apart with 3/0 vicryl sutures between skin flap and pectoral muscle. Results: Age, body mass index and tumour diameter were comparable between the groups. The mean duration of operation was 111.44 ± 7.045 min in conventional and 124.5 ± 6.39 min in quilting (P = 0.0001). The mean drain output for conventional group was not significantly different from quilting group. In quilting, some area developed dimpling which resolved within a week. A total of 21 (30%) patients in the conventional group and 10 patients (14.3%) in the quilting group developed seroma (P = 0.041). The mean frequency and amount of seroma aspiration were significantly lower in the quilting group. Shoulder movement limitation and analgesia use showed no significant difference. Conclusion: Although total amount of drain output, duration of drain, hospital stay and post-operative complications were not different, the incidence of seroma was significantly lower in quilting group. Seroma is treated with more ease in the quilting group as the frequency and amount of aspiration were lower and less frequent follow-up visits were required. Quilting can reduce the seroma incidence in total mastectomy and axillary dissection for breast cancer patients.