Does Abdominal Quilting Suture Prevent Seroma in TRAM Flap Breast Reconstruction?

ABSTRACT

PURPOSE: Seroma formation is still major complication of abdominal donor site after TRAM flap surgery in spite of various efforts to reduce seroma formation such as closed suction drain. We performed a clinical study, that quilting suture at abdominal donor site can prevent seroma formation. METHODS: Between May 2002 and September 2008, we performed 600 breast reconstructions using a unilateral TRAM flap except patients who has smoking history or abdominal scar. We performed 300 breast reconstructions without quilting sutures(A Experimental group) until January 06, and after then 300 reconstructions with quilting sutures (B Control group). We compared total drain output (mL), time to drain removal(days), and donor site complications between two groups. RESULTS: There were no statistical difference at BMI (p=0.28) and time to remove suction drain between two group. (A 8.37, B 9.69)(p=0.40) But, total drain output was reduced with quilting suture. (A 432.5, B 495.2) (p=0.005) And also complication rate was decreased, such as seroma formation, epigastric bulging. (A 1%, B 7%) (p=0.005) CONCLUSION: Quilting suture is a simple and reliable method to reduce seroma formation and abdominal donor site complication.