Flap fixation reduces seroma in patients undergoing mastectomy: a significant implication for clinical practice.

Yvonne Vissers,Geerard Beets,Maarten Snoeijs,James Van Bastelaar,Arianne Beckers

doi:10.1186/s12957-016-0830-8

Abstract

BackgroundSeroma formation is a common complication following mastectomy for invasive breast cancer. Mastectomy flap fixation is achieved by reducing dead space volume using interrupted subcutaneous sutures.MethodsAll patients undergoing mastectomy due to invasive breast cancer or ductal carcinoma in situ (DCIS) were eligible for inclusion. From May 2012 to March 2013, all patients undergoing mastectomy in two hospitals were treated using flap fixation. The skin flaps were sutured on to the pectoral muscle using polyfilament absorbable sutures. The data was retrospectively analysed and compared to a historical control group that was not treated using flap fixation (May 2011 to March 2012).ResultsOne hundred and eighty patients were included: 92 in the flap fixation group (FF) and 88 in the historical control group (HC). A total of 33/92 (35.9 %) patients developed seroma in the group that underwent flap fixation; 52/88 (59.1 %) patients developed seroma in the HC group (p = 0.002). Seroma aspiration was performed in 14/92 (15.2 %) patients in the FF group as opposed to 38/88 (43.2 %) patients in the HC group (p < 0.001).ConclusionsFlap fixation is an effective surgical technique in reducing dead space and therefore seroma formation and seroma aspirations in patients undergoing mastectomy for invasive breast cancer or DCIS.

Highlights

Seroma formation is a common complication following mastectomy for invasive breast cancer
Historical control group (HC) From May 2011 to March 2012, patients underwent conventional wound closure using subcutaneous and Results In total, 835 breast cancer surgeries were performed in both 10-month intervals
This study demonstrates that reduction of the dead space after mastectomy using flap fixation reduces seroma formation and seroma aspirations

Summary

Introduction

Seroma formation is a common complication following mastectomy for invasive breast cancer. Seroma formation, a collection of serous fluid that contains blood plasma and/or lymph fluid, is a common side effect after mastectomy. It has an incidence of 3 to 85 % [1], and some surgeons regard seroma formation as an inherent part of breast cancer surgery. Seroma formation and its sequelae form the mainstay of complications in breast cancer surgery, varying from delayed wound healing, infection, skin flap necrosis and patient discomfort [2]. Seroma formation continues to be a problem for patients undergoing surgery of the breast and/or axilla for invasive breast cancer.

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