Technical aspects of flap fixation after mastectomy for breast cancer: Guidelines for improving seroma-related outcome.
breast cancer
flap fixation
mastectomy
seroma
sutures
Journal
Journal of surgical oncology
ISSN: 1096-9098
Titre abrégé: J Surg Oncol
Pays: United States
ID NLM: 0222643
Informations de publication
Date de publication:
Jan 2023
Jan 2023
Historique:
revised:
10
08
2022
received:
05
07
2022
accepted:
18
09
2022
pubmed:
30
9
2022
medline:
25
2
2023
entrez:
29
9
2022
Statut:
ppublish
Résumé
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. 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. 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. 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.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
28-33Informations de copyright
© 2022 Wiley Periodicals LLC.
Références
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