EVALUATION OF MASTECTOMY FLAPS FIXATION VERSUS CONVENTIONAL METHOD IN REDUCTION OF SEROMA AFTER MODIFIED RADICAL MASTECTOMY

Background: Post-operative seroma is a common complication that occurs after modified radical mastectomy, due to accumulation of fluid in the dead space between skin flaps and the underlying chest wall and axilla. The aim of this study is to evaluate the effect of fixation of flaps by suturing to the chest wall muscle on the seroma formation. Patients and Methods: Our prospective study was done in general surgery department, Zagazig University, from Jan 2016 to Nov. 2017. Included 70 female patients with breast cancer operated by modified radical mastectomy, the patients were classified in to two groups (A,B) each group 35 female patients(N=35). Group (A) operated by quilting flap fixation technique while group (B) operated by conventional method. The patients were followed up for one month and both preoperative and postoperative data are recorded, reviewed and statistically analysed for comparison between the two groups. Results: The preoperative results shows nearly similar results between the two groups regarding the age and body mass index .The breast laterality, the comorbidity (diabetes mellitus (DM), hypertension (HTN), anticoagulant drugs) and stages (T,N) shows small difference between the two groups. the post-operative results shows no significant difference in the operative time, number of Infected seroma, Haematoma and Infected wound (P˃0.05).Total amount of drained fluid (ml) ,the duration of drainage (day), Seroma post drain removal and number of seroma needed aspiration all shows significant difference between the two groups (P<0.05). Conclusion: Reduction of the dead space during modified mastectomy by suturing and fixation of the skin flaps to the chest wall is a good technique to decrease post-operative seroma.