A Comparison of Seroma Formation with and without Quilting of Skin Flaps in Modified Radical Mastectomy

Background: Seroma formation is a common complication following modified radical mastectomy (MRM), often resulting in prolonged recovery and additional interventions. Quilting of skin flaps is a technique proposed to reduce fluid accumulation and improve postoperative outcomes. Objective: This study aims to compare seroma formation rates and other clinical outcomes between patients undergoing MRM with and without quilting of skin flaps. Methods: This randomized controlled trial was conducted at the Department of Surgery, Allama Iqbal Memorial Teaching Hospital, Sialkot from August 2023 to August 2024, with 60 female patients diagnosed with stage II or III breast carcinoma undergoing MRM. The participants were randomly assigned to two groups: Group I (quilted flaps, n=30) and Group II (non-quilted flaps, n=30). Results: Seroma formation occurred in 13.33% of patients in Group I and 63.33% in Group II (p<0.001). The mean drain output was significantly lower in Group I (40 ml/day) compared to Group II (110 ml/day) (p<0.01). Postoperative pain, measured using the VAS, was significantly lower in Group I (mean = 3.5) compared to Group II (mean = 6.8) (p<0.05). Wound healing was more favorable in Group I, with 93.33% showing normal healing by day 14, compared to 73.33% in Group II (p<0.05). The length of hospital stay was shorter in Group I (mean = 4.1 days) compared to Group II (mean = 6.5 days) (p<0.01). Conclusions: It is concluded that quilting of mastectomy flaps significantly reduces seroma formation, postoperative drain output, pain, and promotes better wound healing, leading to a shorter hospital stay.