Effect of flap fixation technique in modified radical mastectomy on incidence of postoperative seroma formation

Abstract

Objective: To determine the efficacy of flap fixation technique on formation of postoperative seroma after modified radical mastectomy. Study Design: Quasi-experimental study. Place and Duration of Study: General Surgery Department, PIMS Hospital, Islamabad, from August 2014 to February 2015. Methodology: This study included 70 female patients, aged 16 to 70 years, undergoing modified radical mastectomy, randomly divided into two groups of 35 each, Group A (flap fixation) and Group B (non-flap fixation). Flap fixation was done by suturing flaps by absorbable, fine suture to underlying pectoralis fascia to obliterate the dead space. Two closed suction drains were used in both groups. Patients were discharged on the second postoperative day. Patients and their attendants were thoroughly educated about record of drain output. Patients followed in OPD after one week. Drains were removed when fluid output was less than 50 ml/day. After removal of drains, patient were again called for weekly follow-ups in surgical OPD. Formation of seroma was diagnosed clinically as collection of fluid under the mastectomy flaps and axilla seen as fluctuant, non-tender swelling. Data was collected on proforma designed for the study and analysed by SPSS version 20.0. Results: Flap fixation group had 2 (5.7%) cases of seroma formation while control group had 3 (8.6%) cases of seroma formation. The difference between both groups statistically was insignificant (p=0.643). Conclusion: Flap fixation technique has no statistically significant effect on reducing frequency of seroma formation in patients undergoing modified radical mastectomy.