<p>The Effect of Low and High Vacuum Drainage on the Postoperative Drainage of Breast Cancer: Insights from a Prospective, Non-Inferiority, Randomized Clinical Trial</p>

Abstract

Background: Vacuum drains have been extensively applied to prevent seroma formation after breast surgery. However, the usage of negative suction drainage is mainly determined by surgeon's experience and preferences. The aim of this study is to prospectively compare the drain effect after breast surgery between the low and high vacuum drains. Methods: This prospectively randomized trial (from January 2018 to June 2019) involved 188 patients who were subjected to modified radical mastectomy (group A, n=128) or immediate breast reconstruction with implants (group B, n=60). In each group, patients were randomized to receive high vacuum drain (pressure=-98 kPa) or low vacuum drain (pressure=-12 kPa) after surgery. Days of drain permanence, which means the duration of drainage, was the primary endpoint. Results: According to the comparison of days of drain permanence, the effect of a low vacuum drain is not inferior to a high vacuum drain in group A (pectoral drain, P<0.001; axillary drain, P<0.001) or group B (submuscular drain, P=0.002). The complications frequently occurred on patients with high vacuum drain (11.7%), such as seroma formation. The expense of low vacuum drain was significantly lower than high vacuum drain in both groups (P<0.01). Conclusion: The drain effect of the low vacuum drain is not inferior to a high vacuum drain in both group A and group B. The low vacuum drain was effective, relatively cheap, and did not increase the incidence of complications; it is therefore more recommended after breast surgery.

An Analysis of Preoperative Inflammatory Indicators That Influence the Drainage Tube Retention Time in Patients with Breast Cancer Surgery

“…On the one hand, continuous negative pressure suction can promote the formation of the capillary, provide sufficient blood supply and establish blood circulation. 29 On the other hand, continuous negative pressure suction can reduce skin tension, promote wound healing, and prevent flap necrosis. 29 At the same time, continuous negative pressure suction can also effectively prevent the spread of bacteria into the incision, and prevent the spread of bacteria into the incision.…”

“… 29 On the other hand, continuous negative pressure suction can reduce skin tension, promote wound healing, and prevent flap necrosis. 29 At the same time, continuous negative pressure suction can also effectively prevent the spread of bacteria into the incision, and prevent the spread of bacteria into the incision. 30 …”

Single vs. double drain in modified radical mastectomy: A randomized controlled trial

“…The use of drains in MRM is one of the most investigated techniques aiming to reduce seroma formation (11,12). Seroma is the most common complication seen after mastectomy and axillary surgery with an incidence of 3-85%, which ultimately leads to wound problems such as impaired healing, dehiscence and infections (13).…”

“…Seroma is the most common complication seen after mastectomy and axillary surgery with an incidence of 3-85%, which ultimately leads to wound problems such as impaired healing, dehiscence and infections (13). There are still controversies regarding the number of drains, duration of drainage, and whether these drains should be at all used in breast cancer surgery (7,9,11). Previously conducted studies have not shown that double drains yield better outcomes than a single drain (4,14).…”

Estratégias para Prevenção do Seroma em Pacientes Submetidos ao Tratamento Cirúrgico do Câncer de Mama: Revisão Sistemática da Literatura

“…Embora exista uma variedade de técnicas descritas para reduzir a formação de seroma, a colocação do dreno no intraoperatório é considerada o padrão ouro para evitar essa complicação 10 . No entanto, isso pode causar dor, aumento do tempo de internação ou redução da qualidade de vida dos pacientes 11 .…”