Comparative Study of Flap Tacking & Compressive Dressing in Reducing Post Mastectomy Seroma Formation

Abstract

Background: Post-mastectomy seroma formation remains a common complication that prolongs hospital stay and delays adjuvant therapy. Various preventive strategies have been proposed, including the use of drains, compression dressings, and flap fixation. This study compared the efficacy of flap tacking with compressive dressing versus conventional closure in reducing postoperative seroma formation in patients undergoing Modified Radical Mastectomy (MRM).

Methods: A prospective comparative study was conducted on 38 female patients with carcinoma breast who underwent MRM at a tertiary care hospital. Seventeen patients (Group A) received flap tacking with compressive dressing, while twenty-one patients (Group B) underwent conventional closure with routine dressing. Postoperative seroma volumes were recorded on postoperative days (POD) 3, 7, 10, 15, and 20. The duration of drain retention and day of drain removal were compared between groups.

Results: The mean seroma volume in the study group was consistently lower across all postoperative days (70 ml vs 120 ml on POD-3; 25 ml vs 75 ml on POD-7; < 5 ml vs 45 ml on POD-10). No measurable seroma was noted after POD-15 in the study group, whereas minimal collections persisted in the control group. The mean time to drain removal was significantly shorter in the flap tacking group (7.8 days) than in the conventional group (13.8 days, p = 0.001). No major wound complications or flap necrosis were observed.

Conclusion: Flap tacking combined with compressive dressing significantly reduces seroma formation and shortens drain duration after mastectomy. The method is simple, effective, and economical, with potential for routine application in breast cancer surgery.