Document Detail

Breast cancer surgery without suction drainage: the impact of adopting a 'no drains' policy on symptomatic seroma formation rates.
MedLine Citation:
PMID:  23380200     Owner:  NLM     Status:  MEDLINE    
AIM: To determine the effect of a 'no drains' policy on seroma formation and other complications in women undergoing breast cancer surgery.
MATERIALS AND METHODS: Before May 2010 drains were routinely used in our unit following mastectomy ± axillary surgery and axillary lymph node dissection (ALND) ± wide local excision (WLE). Since then, a 'no drains' policy has been adopted. Data was collected prospectively between 01/12/06 and 30/11/11 to compare symptomatic seroma, wound infection, re-admission and re-operation rates in women treated with a drain and those without.
RESULTS: 596 women were included in the study. 247 women underwent modified radical mastectomy (MRM) and ALND (Group 1), 184 MRM ± sentinel lymph node biopsy (SLNB)/axillary node sampling (ANS) (Group 2) and 165 ALND ± WLE (Group 3). In group 1, 149 had a drain, in group 2, 62, and in group 3, 50. Within each group, the presence or absence of a drain did not significantly affect the rate of symptomatic seroma, number of aspirations performed, wound infection rates or the incidence of complications requiring re-admission. Having a drain was associated with lower volumes of seroma aspirated. In all three groups, the presence of a drain was associated with a longer hospital stay (p < 0.001).
CONCLUSION: This study suggests that MRM ± ALND/SLNB/ANS and ALND ± WLE can be performed without the use of suction drains without increasing seroma formation and other complication rates. Adopting a 'no-drains' policy may also contribute to earlier hospital discharge.
J C Taylor; S Rai; F Hoar; H Brown; L Vishwanath
Publication Detail:
Type:  Journal Article     Date:  2013-02-04
Journal Detail:
Title:  European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology     Volume:  39     ISSN:  1532-2157     ISO Abbreviation:  Eur J Surg Oncol     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-11     Completed Date:  2013-04-25     Revised Date:  2013-10-21    
Medline Journal Info:
Nlm Unique ID:  8504356     Medline TA:  Eur J Surg Oncol     Country:  England    
Other Details:
Languages:  eng     Pagination:  334-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2013. Published by Elsevier Ltd.
Department of Breast Surgery, City Hospital, Sandwell and West Birmingham NHS Trust, Dudley Road, Birmingham B18 7QH, UK.
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MeSH Terms
Breast Neoplasms / surgery*
Case-Control Studies
Great Britain / epidemiology
Length of Stay
Mastectomy, Modified Radical / adverse effects,  methods*
Middle Aged
Patient Readmission / statistics & numerical data
Prospective Studies
Reoperation / statistics & numerical data
Seroma / epidemiology*,  prevention & control
Surgical Wound Infection / epidemiology
Treatment Outcome
Comment In:
Eur J Surg Oncol. 2013 Sep;39(9):1036   [PMID:  23810333 ]
Eur J Surg Oncol. 2013 Sep;39(9):1037   [PMID:  23796440 ]

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