DefinePK

Research Objective

To compare the effect of flap fixation and non-flap fixation for preventing seroma formation depending upon the stage of surgery in patients undergoing mastectomy.

Methodology

Randomized Controlled Trial conducted in Surgical Units of Holy Family Hospital, Benazir Bhutto Hospital, DHQ Hospital (RMU & Allied Hospital) from October 2020 to April 2021. A sample size of 114 patients was included, equally randomized into flap-fixation (Group A) and non-flap fixation (Group B). Patients were followed up to 48 hours postoperatively for seroma formation. Data was analyzed using SPSS, with chi-square test and a p-value of 0.05 considered significant.

Methodology Flowchart

                        graph TD
    A["Patient Recruitment & Inclusion Criteria"] --> B["Randomization into Group A: Flap Fixation & Group B: Non-Flap Fixation"];
    B --> C["Mastectomy Surgery"];
    C --> D["Postoperative Follow-up: 48 hours for Seroma Formation"];
    D --> E["Data Collection"];
    E --> F["Data Analysis using SPSS & Chi-Square Test"];
    F --> G["Comparison of Seroma Formation between Groups"];
    G --> H["Conclusion on Technique Efficacy"];                    

Discussion

Postoperative seroma formation is a common complication of mastectomy, leading to increased risk of infection, delayed recovery, and more hospital visits. Mechanical closure of the dead space between skin flaps and underlying pectoralis fascia, as achieved by flap fixation, appears to be effective in reducing seroma formation. While literature reviews and RCTs generally support flap fixation, this study highlights its significant benefit specifically in stage IIIA breast cancer patients.

Key Findings

A statistically significant difference (p-value < 0.05) for seroma formation was noted only in disease stage IIIA. In Group A (Flap Fixation), seroma formation was noted in 22.8% of patients, while in Group B (Non-Flap Fixation) it was noted in 45.6% of patients.

Conclusion

Patients with stage IIIA undergoing mastectomy are significantly associated with seroma formation. Flap fixation is a more useful technique than non-flap fixation for minimizing post-mastectomy seroma formation.

Fact Check

* Study Period: October 2020 to April 2021. (Confirmed)
* Sample Size: 114 cases. (Confirmed)
* Seroma formation in Group A (Flap Fixation): 22.8% (n=13). (Confirmed)
* Seroma formation in Group B (Non-Flap Fixation): 45.6% (n=26). (Confirmed)

Mind Map