Technical aspects of flap fixation after mastectomy for breast cancer: Guidelines for improving seroma-related outcome.
J Surg Oncol
; 127(1): 28-33, 2023 Jan.
Article
en En
| MEDLINE
| ID: mdl-36173092
ABSTRACT
OBJECTIVES:
Previous studies have identified the added value of flap fixation in reducing seroma formation and its sequelae after mastectomy. The seroma reduction after mastectomy (SAM)-trial proved that sutures were superior to tissue glue. In this article, we will elaborate on the results of the SAM-trial to provide a clear surgical guideline.METHODS:
All patients in the suture flap fixation cohort from the SAM-trial were analyzed if details regarding flap fixation were available. The most optimal number of sutures was determined using a receiving operator characteristics curve. The incidence of seroma formation between patients receiving the most optimal number of sutures and patients receiving fewer sutures was compared.RESULTS:
The most optimal number of sutures proved to be 15. Patients with ≥15 sutures had a lower incidence of seroma formation at every time frame during follow-up. There was a significant difference at 6 weeks (odds ratio [OR] 3.05, 95% confidence interval [CI] 1.09-8.56), 3 months (OR 4.62, 95% CI 1.34-12.92), and 1 year postoperatively (OR 20.48, 95% CI 2.18-192.22). Ten days and 6 months postoperatively did not differ significantly.CONCLUSIONS:
Flap fixation in general, but also the surgical technique influences the incidence of seroma formation after mastectomy. Results suggest a minimum of 15 sutures, spaced approximately 3.7 cm apart.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias de la Mama
/
Mastectomía
Límite:
Female
/
Humans
Idioma:
En
Revista:
J Surg Oncol
Año:
2023
Tipo del documento:
Article
País de afiliación:
Países Bajos