title: Quilting Suture of Mastectomy Dead Space Compared with Conventional Closure with Drain.
abstract: OBJECTIVE
  This study was designed to compare conventional closure with a drain and quilting suture of mastectomy dead space for preventing wound seroma.
  
  
  METHODS
  Consecutive patients undergoing mastectomy for breast cancer were included in this retrospective observational study. Patients received conventional closure with drainage or quilting suture for wound closure. Propensity score (PS) matching was performed based on potential confounders to minimize selection bias. The primary outcome was the rate of type 2 or 3 wound seroma according to the common terminology criteria for adverse events (CTCAE) definition.
  
  
  RESULTS
  A total of 119 patients were included (quilting suture n = 59; conventional closure n = 60). Type 2 or 3 seroma was observed in 6.8 % of the quilting suture group and 21.7 % of the conventional closure group (crude odds ratio 0.26; 95 % confidence interval 0.08-0.86; p = 0.03). The overall seroma rate was 15.2 % in the quilting suture group and 51.7 % in the conventional closure group (p < 0.001). Persistent pain at days 15-21 was significantly less frequent in the quilting suture group than in the conventional suture group. PS matched analysis confirmed these findings, in particular the lower rate of type 2 or 3 seroma in the quilting suture group than in the conventional closure group (PS-matched odds ratio 0.16; 95 % confidence interval 0.04-0.72; p = 0.02).
  
  
  CONCLUSIONS
  Quilting suture of the mastectomy dead space is associated with significantly less frequent seroma than conventional closure with drain.
authors.affiliation: Department of Gynecology, CHRU de Tours, Tours, France. l.ouldamer@chu-tours.fr.|INSERM Unit 1069, Tours, France. l.ouldamer@chu-tours.fr.|Université François-Rabelais de Tours, PRES Centre-Val de Loire Université, Tours, France. l.ouldamer@chu-tours.fr.
authors.forename: Lobna
authors.initials: L
authors.lastname: Ouldamer
authors.affiliation: Université François-Rabelais de Tours, PRES Centre-Val de Loire Université, Tours, France.|INSERM, CIC 1415, Tours, France.|CHRU de Tours, Tours, France.
authors.forename: Agnès
authors.initials: A
authors.lastname: Caille
authors.affiliation: Université François-Rabelais de Tours, PRES Centre-Val de Loire Université, Tours, France.|INSERM, CIC 1415, Tours, France.|CHRU de Tours, Tours, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Giraudeau
authors.affiliation: Department of Gynecology, CHRU de Tours, Tours, France.|Université François-Rabelais de Tours, PRES Centre-Val de Loire Université, Tours, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Body
mesh_terms: D001943:Breast Neoplasms / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty; D008408:Mastectomy; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D049291:Seroma / Q000517:prevention & control*; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000517:prevention & control; D013536:Suture Techniques; D014014:Tissue Adhesives
chemical_list: D014014:Tissue Adhesives