Background: This study is designed to evaluate the effects of the quilting suture in the donor site of the transverse rectus abdominis musculocutaneous (TRAM) flap in breast reconstruction.  Methods: The use of the quilting suture in closing the abdominal flap causes a collapse of the dead space and allows flap rest, thus ameliorating the factors that interfere with their adherence and reducing complications. From January 2004 to March 2005, 30 breast reconstructions using a pedicled transverse rectus abdominis musculocutaneous flap were performed. The sample was randomly distributed into two groups: 15 patients with the quilting suture (Group A) and 15 patients without the quilting suture (Group B). The study focused on: daily drain output (ml), time to drain removal (days) and possible donor site complications (%).
Results: Group A presented an average of 4.2 days to remove the drain and Group B, 6.93 days, with a statistically significant difference (p<0.001). As to total volume upon removal of the drain, Group A presented an average of 434.7 ml and Group B, 620.7 ml, with a statistically significant difference (p=0.002). Group A presented 13.3% of complications at the donor site and Group B, 53.3%, with a statistically significant difference (p=0.05). Conclusion: The results allow us to conclude that the use of the quilting suture in the transverse rectus abdominis musculocutaneous flap donor site reduces the permanence of drains, total volume of tissue fluids upon drain removal and complication rates.