Service de Gynécologie Obstétrique, CHU Amiens Picardie, 1 Rond-Point Bd du Pr Christian Cabrol, 80000, Amiens, France.
Service de Gynécologie, CH Compiègne, 8 Avenue Henri Adnot, 60200, Compiègne, France.
Sci Rep. 2023 Feb 2;13(1):1898. doi: 10.1038/s41598-023-29154-2.
Worldwide, mastectomy for breast cancer is one of the most frequently performed surgical procedures. As one of the main complications of mastectomy, seroma is associated with pain, infections and a prolonged hospital stay. We performed a prospective multicenter randomized trial to assess the efficacy and esthetic outcomes associated with quilting the skin flap. Eighty-seven patients were included. The proportion of patients with seroma on postoperative day 15 was significantly lower in the quilting group (12 out of 39 (30.8%)) than in a control group with conventional wound closure (21 out of 40 (52.5%); P = 0.05). The mean breast seroma volume was significantly lower in the quilting group (130.2 mL) than in the control group (236.8 mL; P = 0.02). There were no differences in the esthetic outcomes. The pain level on day 1 was similar in the quilting and control groups (mean visual analog scale score: 2.5 vs. 2.1, respectively; P = 0.3). Quilting the skin flap was associated with a lower prevalence of seroma and a lower seroma volume, and did not worsen the esthetic outcomes or pain levels. This technique is technically straightforward and should be offered to all patients scheduled for mastectomy.
在全球范围内，乳腺癌乳房切除术是最常进行的手术之一。作为乳房切除术的主要并发症之一，血清肿会导致疼痛、感染和延长住院时间。我们进行了一项前瞻性多中心随机试验，以评估缝合皮瓣与美容结局的关系。共纳入 87 例患者。与常规缝合组（40 例中有 21 例，52.5%）相比，皮瓣缝合组（39 例中有 12 例，30.8%）术后第 15 天血清肿的患者比例显著降低（P=0.05）。皮瓣缝合组的乳房血清肿体积（130.2 毫升）显著低于常规缝合组（236.8 毫升；P=0.02）。两组在美容结局方面没有差异。皮瓣缝合组与常规缝合组在第 1 天的疼痛水平相似（平均视觉模拟评分：2.5 分和 2.1 分；P=0.3）。缝合皮瓣可降低血清肿的发生率和体积，且不会恶化美容结局或疼痛水平。该技术操作简单，应提供给所有计划接受乳房切除术的患者。
