Volume 24, Issue 103, May - June, 2020

A comparative study to evaluate the effect of obliteration of dead space of mastectomy flaps

Azeem Javed Aalam¹, Pankaj Gharde^2♦, Meenakshi Yeola³

¹Resident, Department of Surgery, JNMC, Sawangi (M), Wardha; Email: drazeemaalam@gmail.com
²Professor, Department of Surgery, JNMC, Sawangi (M), Wardha; Email: pankaj_nandini75@yahoo.com
³Professor & Head, Department of Surgery, JNMC, Sawangi (M), Wardha; Email: drmeenu7@rediffmail.com

^♦Corresponding author
Professor, Department of Surgery, JNMC, Sawangi (M), Wardha, India. Email: pankaj_nandini75@yahoo.com

ABSTRACT

Background: Breast cancer has become a fast-growing cancer in India and is now the most common cancer in Indian women which has replaced cervical cancer. Multiple studies have compared operative procedure as risk factors for seroma formation. A high incidence of surgical site infection (SSI) lead to longer hospital stays, readmissions and re-operations, worse cosmetic outcomes, delays in initiating adjuvant therapy, resulting in additional costs and worse results. Material & Methods: A prospective interventional case control study including diagnosed cases of carcinoma breast. 72 female patients were enrolled, 36 in each limb i.e. Group A (Interventional) and Group B (Conventional), between July 2017 to August 2019. The entire patient underwent Modified Radical Mastectomy (MRM) followed by flap fixation in group A. Post-operative total amount of seroma drained and related characteristics were assessed. Results: Mean age of patients was 52.79 years, majority had infiltrating ductal carcinoma with T2 lesions and in Stage II category, overall 9.72 % had seroma formation, flap necrosis was more in interventional group, the mean total drain were 39.89 ± 16.42 ml in interventional group & 50.78 ± 18.46 ml in conventional group. Conclusion: Dissection technique is an important factor affecting the seroma formation in post-operative period, electrocautery dissection reduces operative blood loss and postoperative drain output. Closure of the dead space by suturing mastectomy flaps reduces the total volume of drained fluid and SSI. A large, multicentric, randomized control trial of high quality is required in order to strengthen the current evidence.

Keywords: Modified Radical Mastectomy, Flap Fixation, Seroma, Surgical Site Infection (SSI)

Medical Science, 2020, 24(103), 1042-1051

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