An original flap fixation technique with suturing to the fascia of serratus anterior for reducing seroma after mastectomy: a single-center retrospective study.

Abstract

Purpose: Seroma formation is a common complication of mastectomy. Recently, flap fixation using sutures was shown to significantly reduce the number of seroma aspirations. We attempted a new flap fixation technique to reduce seromas in patients undergoing mastectomy with a sentinel node biopsy (SLNB).

Methods: At Aichi Medical University, 469 patients with clinical stage 0-II breast cancer underwent mastectomy with an SLNB in 2018-2022. There were 47 patients who underwent flap fixation using sutures (study group) and 422 who underwent conventional wound closure (control group).

Results: In patients undergoing mastectomy with an SLNB, the drainage tube was removed within five days in the control group and three days in the study group. The median total in-hospital drainage volumes were 200 mL in the control group and 114 mL in the study group. After discharge, the study group had fewer seroma aspirations than did the control group. The total seroma volumes were 242 mL in the control group and 134 mL in the study group (p < 0.001). These results were the similar regardless of body mass index.

Conclusions: Our flap fixation technique resulted in approximately half of the usual total drainage volume. Many patients do not require outpatient visits for seroma aspiration, thus simplifying postoperative management.