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Quilting Suture Technique After Mastectomy: A Meta-Analysis
Eleni Drivas1, Mahir Gachabayov1, Agon Kajmolli1
1Department of Surgery, Westchester Medical Center, Valhalla, NY, USA.
The American Surgeon
|May 5, 2023
Summary
The quilting suture (QS) technique significantly reduces seroma rates after mastectomy compared to conventional closure (CC). However, QS did not show significant differences in hematoma, surgical site infection, or flap necrosis rates.
Area of Science:
- Oncology
- Surgical Innovation
- Evidence-Based Medicine
Background:
- Limited high-level evidence exists for the quilting suture (QS) technique in mastectomy wound outcomes.
- Systematic review and meta-analysis needed to evaluate QS versus conventional closure (CC).
Approach:
- Systematic review and meta-analysis of studies on adult women with breast cancer undergoing mastectomy.
- Primary endpoint: postoperative seroma rate. Secondary endpoints: hematoma, surgical site infection (SSI), and flap necrosis rates.
- Utilized Mantel-Haenszel method with random-effects model; calculated number needed to treat.
Key Points:
- Thirteen studies (1748 patients) were analyzed.
- QS significantly reduced postoperative seroma rates compared to CC (OR = 0.32; P < .0001).
- No significant differences were found in hematoma, SSI, or flap necrosis rates between QS and CC.
Conclusions:
- The quilting suture (QS) technique is associated with a significant reduction in seroma formation after mastectomy.
- While QS improves seroma rates, it does not appear to impact rates of hematoma, surgical site infection, or flap necrosis.
