Quilting suture after mastectomy in prevention of postoperative seroma: A prospective observational study

Objectives. - The occurrence of a postoperative seroma is the main complication of mastectomy. In 2011, Ouldamer et al. adapted a quilting technique used in reconstructive surgery in mastectomy closure. The aim of this study is to evaluate the impact of quilting in the prevention of postoperative seroma. Patients and methods. - This is an observational prospective study to the Centre Hospital-University of Tours. Hundred and forty-four patients who underwent a mastectomy between January 1st, 2011 and October 1st, 2012 were included. Patients were divided into 2 groups, one with a classic wound closure with drainage and the second with quilting suture of skin flaps to the underlying musculature after mastectomy without drainage. Results. - Quilting suture significantly reduces the postoperative seroma appearance (OR = 0.15; CI95% [0.06-0.39]; P <0.001). Operative time is increased by 20 minutes in the quilted group (P <0.001). Postoperative pain is not changed by quilting. The duration of hospitalization is significantly shorter (5.09 +/- 1.46 days versus 6.49 +/- 2.77 days; P <0.001). Quality of the healing and appearance of the scar, rated by patients, are identical in both groups. Conclusion. - Quilting is an effective method not only for prevention of seroma, but also for reducing of hospitalization duration, without increasing of postoperative pain and complications. (C) 2015 Published by Elsevier Masson SAS.