Quilting After Mastectomy Is Associated With Decreased Postoperative Seroma Rates in Patients With Breast Cancer: A Meta-Analysis

Author Type(s)

Faculty

Document Type

Abstract

Publication Date

11-2021

DOI

10.1016/j.jamcollsurg.2021.07.033

Journal Title

Journal of the American College of Surgeons

Department

Surgery

Abstract

INTRODUCTION: There is no level 1a evidence as to whether quilting sutures allow preventing postoperative seroma in patients undergoing mastectomy for breast cancer. The aim of this study was to evaluate whether quilting sutures (QS) are associated with lower rates of seroma and other surgical site occurrences, as compared to conventional closure (CC).

METHODS: MEDLINE, Pubmed, and Cochrane Library were systematically searched. The inclusion criterion was adults with breast cancer undergoing mastectomy. QS was defined as a suturing of the skin flaps to the underlying pectoralis major with several parallel rows of running sutures after mastectomy. The primary endpoint was postoperative seroma rate. Secondary endpoints included hematoma and surgical site infection (SSI) rates. Mantel-Haenszel method with random-effects model was used for meta-analysis. Number needed to treat (NNT) was calculated to assess for clinical relevance of statistical findings.

RESULTS: Seven studies, totaling 916 patients (460 QS and 456 CC), were included. Seroma rates were statistically and clinically significantly lower in patients with QS [OR (95%CI) = 0.250 (0.084, 0.5); pFigure). Hematoma rates [OR (95%CI) = 1.057 (0.628, 1.779); p = 0.834; NNT = 167] as well as SSI rates [OR (95%CI) = 0.530 (0.255, 1.1); p = 0.088; NNT = 18] did not significantly between QS and CC.

CONCLUSION: This meta-analysis found that QS was associated with significantly decreased rates of seroma as compared to CC in patients undergoing mastectomy for cancer.

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