Half versus full vacuum suction drainage after modified radical mastectomy for breast cancer- a prospective randomized clinical trial[ISRCTN24484328]

Abstract

Background: Suction drains are routinely used after modified radical mastectomy and are an important factor contributing to increased hospital stay as the patients are often discharged only after their removal. Amongst various factors that influence the amount of postoperative drainage, the negative suction pressure applied to the drain has been reported to be of great significance. While a high negative suction pressure is expected to drain the collection and reduce the dead space promptly, it may also prevent the leaking lymphatics from closing and lead to increased drainage from the wound. Against this background a prospective randomized clinical study was conducted to compare the amount and duration of drainage between a half negative suction and full vacuum suction drainage in patients following modified radical mastectomy. The associated postoperative morbidity was also compared between the two groups.

Subcutaneous versus Intraarticular Indwelling Closed Suction Drainage after TKA: A Randomized Controlled Trial

“…Subcutaneous indwelling closed-suction drainage has been used in other types of surgery including breast and thyroid [9,39]. We have used the subcutaneous indwelling method for 3 years and have noted no particular problems with blood loss or wound complications.…”

Ten Commandments of Safe and Optimum Mastectomy for Breast Cancer

“…It is also recommended to stay below the superior most IBN in order not to interfere with the lymphatic drainage of the upper extremity. Keeping dissection below the superior most IBN has been observed in various studies to be associated with lower incidence of upper limb lymphedema [4][5][6]. If one decides to sacrifice the intercostobrachial nerves, it is recommended that a cold knife rather than diathermy should be used to prevent postoperative neuralgia (Fig.…”

“…14) After a thorough saline wash, the wound is closed after leaving two suction drains (or only one) in situ, one each for the axilla and flaps. The author in a randomized controlled study (ISRCT N number-24484328) observed that the seroma rates are lower with the use of half suction rather than full suction drains [6]. Fig.…”

“…The author recommends encouraging the patient to start with shoulder and arm exercises as soon as possible. This, combined with the use of half suction drainage has been found to significantly reduce seroma formation in a randomized controlled study conducted by the author [6]. The use of diathermy as opposed to cold knife has also not been found to make any significant difference in seroma rates [6].…”

Optimum Axillary Dissection in Breast Cancer—is Angular Vein a Reliable Spatial Landmark?

“…The survival drops by nearly 50% in patients with positive axillae. The "gold standard" method of assessing the axilla is to establish the histological evidence of disease in the nodes, making assessment of axilla mandatory even in node negative patients [1][2][3].…”