Use of abdominal quilting sutures for seroma prevention in TRAM flap reconstruction: a prospective, controlled trial.
This study is designed to evaluate the effect of abdominal quilting sutures on the incidence of abdominal seroma formation in patients undergoing pedicled transverse rectus abdominis musculocutaneous (TRAM) flap reconstruction. It is theorized that the use of such sutures during closure of abdominal flaps will collapse dead space, thus preventing abdominal seroma formation. A total of 71 consecutive patients undergoing pedicled TRAM flap breast reconstruction were randomly assigned to receive abdominal quilting sutures or to undergo a standard abdominal closure. Primary outcome measures included: daily drain output for the first 3 postoperative days, time to drain removal, and seroma formation. Drain output per day decreased with the use of abdominal quilting sutures; however, the time to drain removal was not significantly affected. Most importantly, there was no significant decrease in the incidence of seroma formation with the use of abdominal quilting sutures in this series.
McCarthy
Colleen
C
Division of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada. mccarthy_colleen@hotmail.com
Lennox
Peter
P
Germann
Eva
E
Clugston
Patricia
P
D000005:Abdomen; D000009:Abdominal Muscles / Q000637:transplantation*; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D011183:Postoperative Complications; D011300:Preoperative Care; D019651:Plastic Surgery Procedures / Q000379:methods*; D049291:Seroma / Q000209:etiology / Q000517:prevention & control*; D013524:Surgical Flaps; D013537:Sutures