Amato Fernando Campos Moraes, Neto Miguel Sabino, Trincado Marcelo Moraes, de Lima Paulo Maranhão Gusmão Pincovsky, Aivazoglou Laís Uyeda, Velloni Fernanda Garozzo, Felix Gabriel de Almeida Arruda, Ferreira Lydia Masako
Division of Plastic Surgery, Federal University of São Paulo, Rua Botucatu, 740 - 2º andar, Vila Clementino, São Paulo, SP, Brazil.
Department of Radiology, Federal University of São Paulo, São Paulo, SP, Brazil.
Aesthetic Plast Surg. 2025 May 12. doi: 10.1007/s00266-025-04893-x.
Gynecomastia is characterized by enlarged breast tissue in men and is often caused by genetic or endocrinological disorders, cancer, or medication use, with idiopathic causes being the most common. If no clinically treatable cause is identified and the condition persists for more than two years, surgical treatment is indicated. This typically involves adenectomy with or without liposuction and resection of excess skin when necessary. Major complications include hematoma, seroma, infection, and dehiscence. Quilting sutures, as previously described in abdominoplasty, can minimize dead space and reduce hematoma and seroma formation.
This study aimed to compare the efficacy of quilting sutures and suction drains in preventing hematoma and seroma formation after adenectomy for gynecomastia.
Thirty-eight gynecomastia patients eligible for adenectomy were randomized into two groups: one with intraoperative quilting sutures (Group 1) and another with vacuum drains (Group 2). The patients were followed up postoperatively using clinical examinations and ultrasonography. Fluid collection > 10 mL was drained when necessary.
Eight patients in Group 1 (40%) and five in Group 2 (28%) developed fluid collections, with no significant difference between the groups. No surgical correction was required for hematoma or seroma. Suction drains seem to give better results regarding seroma, but with no statistical difference.
This study showed no difference in the use of drains or quilting sutures to prevent seromas or hematomas in the correction of gynecomastia.
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男性乳腺增生的特征是男性乳腺组织增大，通常由遗传或内分泌紊乱、癌症或药物使用引起，其中特发性原因最为常见。如果未发现临床上可治疗的病因且病情持续超过两年，则需进行手术治疗。这通常包括腺体切除术，必要时可进行抽脂和切除多余皮肤。主要并发症包括血肿、血清肿、感染和伤口裂开。如之前在腹壁整形术中所描述的，褥式缝合可将死腔最小化，并减少血肿和血清肿的形成。
本研究旨在比较褥式缝合与负压引流在预防男性乳腺增生腺体切除术后血肿和血清肿形成方面的疗效。
38例符合腺体切除术条件的男性乳腺增生患者被随机分为两组：一组术中采用褥式缝合（第1组），另一组采用负压引流（第2组）。术后通过临床检查和超声对患者进行随访。必要时，引流超过10 mL的积液。
第1组有8例患者（40%）出现积液，第2组有5例患者（28%）出现积液，两组之间无显著差异。血肿或血清肿无需手术矫正。负压引流在血清肿方面似乎效果更好，但无统计学差异。
本研究表明，在矫正男性乳腺增生时，使用引流或褥式缝合在预防血清肿或血肿方面没有差异。
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