Seroma at the Donor Site of the TRAM Flap, With or Without Quilting Suture: A Comparative Study Using Ultrasound

Study Overview
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Brief Summary
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Patient undergoing breast reconstruction with lower abdominal flap, benefit when points are used for membership (between the aponeurosis of the abdominal flap and underlying muscles) for closing the donor area, where there is reduced incidence of complications.

Detailed Description
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This study evaluated seroma formation at the donor site of the TRAM patients who underwent breast reconstruction. Forty-eight breast reconstructions were performed using the bipedicled TRAM flap. The patients were randomly allocated into three groups of 16 participants each: DN group, use of suction drains but no quilting sutures between the remaining abdominal flap and musculoaponeurotic layer of the anterior abdominal wall; QS+DN group, use of quilting sutures and suction drains; and QS group, use of quilting sutures but no suction drains. In order to determine seroma formation, ultrasound examinations were performed on postoperative days 7 and 14 in 5 regions of the abdominal wall: epigastric, umbilical, hypogastric, right iliac, and left iliac regions.

Official Title
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Seroma at the Donor Site of the TRAM Flap, With or Without Quilting Suture.

Conditions
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Seroma

Intervention / Treatment
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* Procedure: quilting suture


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: were age between 20 and 65 years body mass index (BMI) ≤ 30 kg/m2 non-smokers. Exclusion criteria: no skin excess in the infraumbilical region previous abdominoplasty uncontrolled systemic disease such as diabetes mellitus and arterial hypertension collagen diseases psychiatric disorders large weight loss and/or postoperative abdominal scars that could hinder flap vascularization.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: no quilting sutures but drains<br> | Procedure: quilting suture<br>* quilting sutures and drains quilting sutures but no drains<br>* Other names: points;|
| Experimental: quilting sutures and drains<br> | Procedure: quilting suture<br>* quilting sutures and drains quilting sutures but no drains<br>* Other names: points;|
| Experimental: quilting sutures but no drains<br> | Procedure: quilting suture<br>* quilting sutures and drains quilting sutures but no drains<br>* Other names: points;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reducing seroma in donor site of the TRAM flap | Seroma formation was identified clinically and confirmed by ultrasound examination. Clinical examination consisted of evaluation of early symptoms (bulging and distension of the skin, signs of fluid accumulation), palpation, and percussion. Ultrasound examination was performed on postoperative days 7 and 14 to detect the presence of seroma at the TRAM flap donor site. The patients were placed in the supine position during the examination. Upon detection of seroma, ultrasound-guided puncture was performed, and the number of punctures and volume of seroma aspirated were recorded. | 15 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Quilting suture, seroma, Procedure, Surgery