Discussion
postoperative pain, seroma, breast cancer
SITE INFECTION, SEROMA, BREAST CANCER
Our results showed that quilting after mastectomy is associated with a significantly lower seroma prevalence 15 days after surgery (30.8% in the quilting group Surgery still accounts for a large proportion of breast cancer treatments. For many years now, breast cancer surgeons have striven to find the best way of reducing seroma after breast surgery and (in some cases) axillary lymph node dissection or not. Firstly, closed vacuum drainage was developed to limit seroma. In a study published in 1993, patients with skin flap fixation had three times less seroma than other patientsOur results are in line with other studies of the same topic. Here, we showed that in the quilting group, seroma was significantly less prevalent on postoperative day 15 and the seroma drainage volume was significantly lower. In Sakkary et al.’s 2010 study, 40 patients scheduled for mastectomy were randomly assigned a flap fixation (interrupted suture) group or a conventional wound closure group. The patients in both groups underwent vacuum drainage. The seroma prevalence was significantly lower in the flap fixation group (10%) than in the control group (40%; Quilting also reduces the number of seroma drainage procedures. According to the literature, reducing seroma incidence and seroma volume decreases the risk of surgical site infections—although we did not find that in the present studyThe seroma volume drained from mastectomy area during the hospital stay was significantly lower in the quilting group because the duration of drainage was shorter. Moreover, the proportion of patients requiring seroma drainage was also significantly lower in the quilting group at day 15 and at day 30. In Khater et al.’s study, the total drainage volume was also significantly lower for patients in the quilting groupFixing the skin flap by quilting typically takes longer than fixing it with separate sutures. Indeed, the operating time was significantly longer in the quilting group than in the control group in our study (mean: 128.7 min) and in the study by Khater et al. (mean: 127 min)Our prospective trial has evidenced a significant reduction in the length of stay in the skin flap fixation group (3.7 days, vs. 4.8 days in the control group; Ten Wolde et al. found that postoperative pain was a limitation of skin fixationA number of other skin flap fixation techniques have been developed. Some investigators have studied the use of TissuGlu