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

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

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.

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.

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.