Drainless mastectomy: Is it safe and effective?

Baker, Elizabeth A.; Piper, Jennifer

doi:10.1016/j.surge.2015.12.007

Cited by 29 publications

(27 citation statements)

References 17 publications

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“…Similar findings were obtained by Zielinski et al in a prospective study (20). Baker et al could not establish a correlation between weight of the resected tissue and seroma formation (9). In contrast to Sforza et al (39) we could not demonstrate any clear evidence for a correlation between seroma formation and the BMI or the nicotine consumption of the patients.…”

Section: Discussionsupporting

confidence: 73%

“…In addition, there is no demonstrated superiority in the use of drains with respect to postoperative seroma formation compared to other methods used to minimize the dead space. Furthermore, the use of drains is associated with pain and discomfort, longer hospital stays and often results in postoperative complications (9). In many studies the effect of use of various surgical instruments (scalpel, electrocautery, ultrasound dissector) (27,28) to open the wound cavity and remove the gland body, the efficacy of postoperatively applied pressure bandages (29) and postoperative immobilization (30) to reduce postoperative seroma formation have been explored.…”

mentioning

confidence: 99%

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The Use of TissuGlu® Surgical Adhesive for Mastectomy with or Without Lymphonodectomy

Öhlinger

Gieron

Rutkowski

et al. 2018

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Section: Discussionsupporting

confidence: 73%

mentioning

confidence: 99%

The Use of TissuGlu® Surgical Adhesive for Mastectomy with or Without Lymphonodectomy

Öhlinger

Gieron

Rutkowski

et al. 2018

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“…[2] A closed suction drain in the surgical field can decrease seroma formation and possibly reduces the risk of infection. [3,4] However, prolonged drain duration may increase infection rate due to ascending infection. [5–7] The optimal timing of drain removal after prosthesis-based breast reconstruction is still unclear.…”

Section: Introductionmentioning

confidence: 99%

Risk of infection is associated more with drain duration than daily drainage volume in prosthesis-based breast reconstruction

et al. 2016

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In prosthesis-based breast reconstruction, drains are used to prevent seroma formation and to reduce the risk of infection. However, prolonged drainage increases the risk of ascending infection. Although the volume often accepted for drain removal is ≤30 mL per day, the optimal timing to remove the drain for best clinical outcome remains controversial.We did a retrospective cohort study of 569 patients of prosthesis-based breast reconstruction with infection rate as the outcome variable; drain duration and last daily drainage volume as the main independent variables. Data on age, smoking history, diabetes mellitus history, body mass index, breast weight, tissue expander size, drain size, number of retrieved lymph nodes, tumor size, number of metastatic lymph nodes, tumor stage, mastectomy type, reconstruction type, submuscular implantation, skin defect, operative time, duration of antibiotics use, chemotherapy, and radiotherapy were collected as covariates. Multivariable logistic regression analysis was used to control for confounding.The total infection rate was 5.1% (29/569). The daily drainage volume ≥30 mL/d at the time of drain removal was not found associated with increased infection rate (P = 0.32). Of the various cutoff values of last daily drainage volume, none was found to be a determinant for drain removal where the risk of infection was concerned. By contrast, drain duration over 21 days significantly increased infection rate (P = 0.001). The multivariable logistic regression analysis showed an increase of 76.2% in the infection rate with each additional week of drain retention (P = 0.001). Breast weight also had a significant influence on risk of infection. Chemotherapy and drain size showed borderline effect on risk of infection whereas the last daily drainage volume was not associated with risk of infectionIn summary, our study revealed that drain duration, rather than the last daily drainage volume, significantly affects the infection rate in prosthesis-based breast reconstruction. We recommend that the drain is better removed no longer than 3 weeks postoperatively and can be removed as early as postoperative day 7, even when the drainage is over 30 mL in a 24-hour period.

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“…Traditionally, surgeons have implemented the use of closed‐suction drains in this setting with the aim of preventing these complications, which can cause discomfort, morbidity, increased follow‐up visits, and possible delay in the beginning of adjuvant therapies . On the other hand, potential benefits of performing breast procedures without using a drain have been increasingly considered . There is lack of modern and official guidelines on use of drains in breast surgery, with no consensus regarding their management and the appropriate use of antibiotics in this setting.…”

mentioning

confidence: 99%

“…2 On the other hand, potential benefits of performing breast procedures without using a drain have been increasingly considered. 3 There is lack of modern and official guidelines on use of drains in breast surgery, with no consensus regarding their management and the appropriate use of antibiotics in this setting. Almost all reports agree with the use of drains after breast procedures, especially if they are associated with reconstruction or axillar lymph node dissection (ALND), but an extreme variability is reported regarding practice patterns.…”

mentioning

confidence: 99%

Practice patterns regarding drains management in breast surgery: Results of a survey of Senonetwork Italia breast centers

Pallara¹,

Fortunato²,

Folli³

et al. 2020

Breast J

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Drainless mastectomy: Is it safe and effective?

Cited by 29 publications

References 17 publications

The Use of TissuGlu® Surgical Adhesive for Mastectomy with or Without Lymphonodectomy

The Use of TissuGlu® Surgical Adhesive for Mastectomy with or Without Lymphonodectomy

Risk of infection is associated more with drain duration than daily drainage volume in prosthesis-based breast reconstruction

Practice patterns regarding drains management in breast surgery: Results of a survey of Senonetwork Italia breast centers

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