The Society of Surgical Oncology, inc.
The American Society of Breast Surgeons.
Annals of Surgical Oncology

Log in | Register

Omitting Postoperative Wound Drainage After Mastectomy With Skin-Flap Quilting

B. ten Wolde MD, F. F. R. Strobbe BSc, M. Schlooz-de Vries MD, F. J. H. van den Wildenberg MD, PhD, M. Keemers-Gels MD, PhD, J. H. W. de Wilt MD, PhD, L. J. A. Strobbe MD, PhD
Breast Oncology
Volume 26, Issue 9 / September , 2019



Seroma is the most frequent complication after mastectomy (ME) and axillary lymph node dissection (ALND). The quilting suture technique, in which skin flaps are sutured to the underlying muscle, was previously investigated and found to reduce seroma incidence after ME and ALND. This study aimed to investigate whether postoperative wound drainage can safely be omitted when quilting sutures are applied.


Two groups with a total of 251 consecutive patients who underwent ME, ALND, or both were retrospectively compared. The first group underwent quilting sutures with wound vacuum drainage, and the second group underwent quilting sutures without wound drainage. The primary outcome was the incidence of postoperative clinically significant seroma (CSS). The secondary outcomes were the incidence of postoperative infection, bleeding complications, wound dehiscence, and flap necrosis.


The group without a postoperative drain (n = 166) had a significantly lower CSS incidence (8.4%) than the group with a postoperative drain (n = 85, 21.2%) (p < 0.05). In the multivariate analysis, no significant predictors were found for seroma formation. Wound complications significantly decreased, from 31.8% in the group with a drain group to 17.5% in the group without a drain (p < 0.05).


This study showed that the postoperative drain can be omitted when quilting sutures are applied in ME, ALND, or both. This facilitates day care mastectomy, eliminating drain-related care, discomfort, and related expenses.

Add a comment

0 comment(s)



Join the conversation!

Follow the journal on Twitter and Facebook

Help to expand the reach of the journal to support the research and practice needs of surgical oncologists and their patients.