Flap Fixation as a Technique for Reducing Seroma Formation in Patients Undergoing Modified Radical Mastectomy: an Instit
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ORIGINAL ARTICLE
Flap Fixation as a Technique for Reducing Seroma Formation in Patients Undergoing Modified Radical Mastectomy: an Institutional Experience Ajith Vettuparambil 1
&
Chandrashekar Subramanya 2
Received: 1 April 2020 / Accepted: 15 September 2020 # Indian Association of Surgical Oncology 2020
Abstract Formation of seroma most frequently occurs after mastectomy and axillary surgery. This study is intended at creating data on whether flap fixation has any role in reducing the seroma formation in patients undergoing the modified radical mastectomy. A prospective comparative study was conducted among 61 patients scheduled for modified radical mastectomy from 1st of January 2017 to 31st of December 2017. Patients were divided into two groups. In the flap fixation group (N = 30), the skin flaps were sutured to the pectoral muscle with Vicryl 3–0 sutures, and in the control group (N = 31), the wound was closed in the conventional methods at the edges. Closed suction drain was used in both groups. Flap fixation group showed a significantly lower frequency of seroma formation compared with the control group. In the flap fixation group, the drain was removed earlier compared with the control group. Mean value of the total amount of fluid drained for the study group was significantly lower than that of control. Flap fixation is a surgical technique which appears to reduce the total volume of fluid drained, the development of seroma, and the need for seroma aspirations. Keywords Modified radical mastectomy . Seroma . Flap fixation . Breast cancer
Introduction The incidence of breast cancer is on the increase in India, and an increasing number of women are undergoing modified radical mastectomy (MRM) as the treatment for breast cancer [1, 2]. Mastectomy is associated with few significant complications. The most common complication is wound seroma, a collection of serous fluid that contains plasma and or lymph fluid, with a reported incidence rate of 3% to 85% [3]. Pathogenesis of seroma is not well understood. Several factors are held responsible for seroma formation.
* Ajith Vettuparambil [email protected] Chandrashekar Subramanya [email protected] 1
Department of surgery, DM Wayanad Institute of Medical Sciences, Wayanad, Kerala 673577, India
2
Department of General Surgery, Mysore Medical College and Research Institute, Mysore, Karnataka 570001, India
The type of breast surgery performed is an important predictor of seroma formation whereas the age of the patient, axillary nodal status, tumor size, and the use of neoadjuvant chemotherapy were not. The use of electrocautery has been demonstrated to increase seroma formation following mastectomy; however, no other surgical devices have proven to be superior in seroma reduction [4]. This study is intended at creating data on whether flap fixation has any role in reducing the seroma formation in patients undergoing modified radical mastectomy in a tertiary care teaching hospital in Karnataka, India.
Methodology A prospective comparative study was cond
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