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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 9/2019

01-09-2019 | Mastectomy | Breast Oncology

Omitting Postoperative Wound Drainage After Mastectomy With Skin-Flap Quilting

Authors: B. ten Wolde, MD, F. F. R. Strobbe, BSc, M. Schlooz-de Vries, MD, F. J. H. van den Wildenberg, MD, PhD, M. Keemers-Gels, MD, PhD, J. H. W. de Wilt, MD, PhD, L. J. A. Strobbe, MD, PhD

Published in: Annals of Surgical Oncology | Issue 9/2019

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Abstract

Background

Seroma is the most frequent complication after mastectomy (ME) and axillary lymph node dissection (ALND). The quilting suture technique, in which skin flaps are sutured to the underlying muscle, was previously investigated and found to reduce seroma incidence after ME and ALND. This study aimed to investigate whether postoperative wound drainage can safely be omitted when quilting sutures are applied.

Methods

Two groups with a total of 251 consecutive patients who underwent ME, ALND, or both were retrospectively compared. The first group underwent quilting sutures with wound vacuum drainage, and the second group underwent quilting sutures without wound drainage. The primary outcome was the incidence of postoperative clinically significant seroma (CSS). The secondary outcomes were the incidence of postoperative infection, bleeding complications, wound dehiscence, and flap necrosis.

Results

The group without a postoperative drain (n = 166) had a significantly lower CSS incidence (8.4%) than the group with a postoperative drain (n = 85, 21.2%) (p < 0.05). In the multivariate analysis, no significant predictors were found for seroma formation. Wound complications significantly decreased, from 31.8% in the group with a drain group to 17.5% in the group without a drain (p < 0.05).

Conclusion

This study showed that the postoperative drain can be omitted when quilting sutures are applied in ME, ALND, or both. This facilitates day care mastectomy, eliminating drain-related care, discomfort, and related expenses.
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Metadata
Title
Omitting Postoperative Wound Drainage After Mastectomy With Skin-Flap Quilting
Authors
B. ten Wolde, MD
F. F. R. Strobbe, BSc
M. Schlooz-de Vries, MD
F. J. H. van den Wildenberg, MD, PhD
M. Keemers-Gels, MD, PhD
J. H. W. de Wilt, MD, PhD
L. J. A. Strobbe, MD, PhD
Publication date
01-09-2019
Publisher
Springer International Publishing
Keywords
Mastectomy
Seroma
Published in
Annals of Surgical Oncology / Issue 9/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-019-07411-x

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