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Background <p>Seroma is the most common complication following modified radical mastectomy (MRM), arising primarily from dead-space accumulation between skin flaps and the chest wall. Quilting of mastectomy flaps obliterates this space mechanically, yet it has not been universally adopted. This trial evaluated the efficacy of flap quilting versus conventional closure in reducing seroma, drain output, and wound complications after MRM.</p> Methods <p>A prospective, single-centre randomized controlled trial (RCT) enrolled 60 women with biopsy-proven breast carcinoma requiring MRM (May 2023 – November 2024). Participants were allocated by sequentially numbered sealed opaque envelopes (1:1 ratio) to Group 1 (conventional closure, <i>n</i> = 30) or Group 2 (quilting with Vicryl 2 − 0, <i>n</i> = 30). Primary outcome: clinically defined seroma requiring aspiration. Secondary outcomes: day-1 drain output, total drain volume, day of drain removal, and wound complications. Data were analysed using SPSS v27; Fisher’s exact test was applied where expected cell counts were below 5.</p> <p>Figure 3. CONSORT Flow Diagram of Participant Recruitment, Randomization, Follow‑up and Analysis</p> Result <p>Groups were comparable in age (45.03 vs. 46.70 years, <i>p</i> = 0.670), comorbidities (<i>p</i> = 0.265), laterality (<i>p</i> = 0.137), and stage (<i>p</i> = 0.147). Seroma occurred in 6 patients (20%) in Group 1 versus none in Group 2 (<i>p</i> = 0.031). Mean day-1 drain output was significantly higher in Group 1 (106.23 vs. 86.83 mL; <i>p</i> = 0.002), as was total drain volume (912.00 vs. 599.33 mL; <i>p</i> = 0.001). Drains were removed earlier in Group 2 (7.83 vs. 10.56 days; <i>p</i> = 0.048). Wound complications were rare and similar between groups (3.33% vs. 0%; <i>p</i> = 0.500).</p> Conclusion <p>Quilting of mastectomy flaps significantly reduced seroma incidence, drain output, and drain duration compared with conventional closure. These results support quilting as a promising adjunct to MRM; however, larger, multicentre trials are warranted before universal adoption.</p>

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Effect of Flap Quilting Versus Non-Quilting on Seroma Formation After Modified Radical Mastectomy: A Prospective Comparative Study

  • 期刊论文

  • 发表日期：

    2026年7月30日

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  • Ankita Singh,
  • Aditya R,
  • Tejashwini G. Kullur

摘要

Background

Seroma is the most common complication following modified radical mastectomy (MRM), arising primarily from dead-space accumulation between skin flaps and the chest wall. Quilting of mastectomy flaps obliterates this space mechanically, yet it has not been universally adopted. This trial evaluated the efficacy of flap quilting versus conventional closure in reducing seroma, drain output, and wound complications after MRM.

Methods

A prospective, single-centre randomized controlled trial (RCT) enrolled 60 women with biopsy-proven breast carcinoma requiring MRM (May 2023 – November 2024). Participants were allocated by sequentially numbered sealed opaque envelopes (1:1 ratio) to Group 1 (conventional closure, n = 30) or Group 2 (quilting with Vicryl 2 − 0, n = 30). Primary outcome: clinically defined seroma requiring aspiration. Secondary outcomes: day-1 drain output, total drain volume, day of drain removal, and wound complications. Data were analysed using SPSS v27; Fisher’s exact test was applied where expected cell counts were below 5.

Figure 3. CONSORT Flow Diagram of Participant Recruitment, Randomization, Follow‑up and Analysis

Result

Groups were comparable in age (45.03 vs. 46.70 years, p = 0.670), comorbidities (p = 0.265), laterality (p = 0.137), and stage (p = 0.147). Seroma occurred in 6 patients (20%) in Group 1 versus none in Group 2 (p = 0.031). Mean day-1 drain output was significantly higher in Group 1 (106.23 vs. 86.83 mL; p = 0.002), as was total drain volume (912.00 vs. 599.33 mL; p = 0.001). Drains were removed earlier in Group 2 (7.83 vs. 10.56 days; p = 0.048). Wound complications were rare and similar between groups (3.33% vs. 0%; p = 0.500).

Conclusion

Quilting of mastectomy flaps significantly reduced seroma incidence, drain output, and drain duration compared with conventional closure. These results support quilting as a promising adjunct to MRM; however, larger, multicentre trials are warranted before universal adoption.