Strategies to prevent seroma formation after mastectomy surgery: A systematic review and meta-analysis

Quilting sutures and flap fixation are the most effective interventions for preventing seroma after mastectomy surgery, with strong supporting evidence and minimal heterogeneity. Output-based drain management and selective use of steroids or adjuncts may further reduce risk in high-risk patients. Routine use of tissue adhesives, harmonic scalpel, or nitroglycerin ointment is not supported by current evidence. Future research should focus on standardized outcome reporting and direct comparisons of effective strategies, particularly in the setting of mastectomy reconstruction.