Role of Quilting Sutures in Reducing Seroma Formation in Latissimus Dorsi Flap Donor Site: A Randomized Controlled Trial

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Author(s): 1. Zain ul Abidin, 2. Ammad Rasul Ghumman, 3. Muhammad Sheraz Raza, 4. Muhammad Umar Asif, 5. Asma Ilyas, 6. Usman Ishaque, 7. Kamran Khalid7

Received: 27/01/2022 | Published: 27/08/2022 | Pages: 35-38 |

Background: The Latissimus Dorsi Flap is a commonly used flap for breast and upper limb reconstruction. One drawback of this flap is donor site seroma formation. The objective of this study is to evaluate the role of quilting sutures in prevention of seroma formation over donor area after latissimus dorsi flap. Methodology: This is a randomized controlled trial conducted at Jinnah burn and reconstructive surgery Centre, Lahore over a duration of 4 years from June 2016 to June 2020. The sample size was 78 patients who were all planned to undergo free latissimus dorsi flap reconstruction. The patients were randomized by the lottery method into two groups of 39 patients each: group A (quilting) patients had their donor sites closed with quilting sutures, whereas and group B (control) patients had their donor sites closed without quilting sutures. Drains were placed in all patients and output was monitored until removal. Results were evaluated by comparing seroma formation, drain output in 48 hours, and drain removal time. Results: Overall 19 patients (24.3%) developed seroma. Quilting technique reduced the incidence as only 2 patients (2.5%) developed seroma, in comparison with non-quilting group in which 17 patients (21.7 %) developed this complication. Quilting group was also associated with decreased total drain output and early drain removal. Conclusion: As compared to traditional method of primary closure of latissimus dorsi flap donor area, quilting suture technique proved to be more effective in preventing post-operative seroma formation.

Keywords | Seroma formation, Latissimus dorsi flap, Quilting sutures