Role of flap fixation during modified radical mastectomy in locally advanced breast carcinoma patients: a randomised control study

Abstract

Background: Treatment of locally advanced breast carcinoma (LABC) patients involves multimodal approach. Modified radical mastectomy (MRM) is preferred in them. Seroma and prolonged drainage are most common post-op complications. This study was conducted to evaluate the effect Flap fixation technique in reducing drain output and seroma in patients with LABC.Methods: 30 stage III breast cancer patients undergoing MRM were included. Prior to skin closure patients were randomised into: test (15) and control group (15). In Test group, skin flaps were sutured to chest wall with vicryl 3-0 at 3 cm intervals and skin was closed with nylon. In conventional group, only skin was closed with nylon sutures. In both the groups conventional closed suction drains were placed. Total drain output, clinically significant seroma, post-operative complications were compared between the two groups.Results: Total drain output in test group (4445 ml) was lesser compared to control group (4801 ml) but not statistically significant (p=0.548), however the percentage reduction of drain output on day 2 was significantly higher in test group (42%) as compared to control group (31.8%) (p=0.04). The clinically significant Seroma formation rates were similar in both groups but the volume of seroma aspirated was significantly lower in test group (p<0.05).Conclusions: The flap fixation technique group had better approximation of skin flaps and chest wall, as evident with reduction of drain output, significant reduction in drain output on post op day 2 and reduction of seroma volume.