The Use of Postoperative Drains Versus No Drains in Reduction Mammoplasty: Does it Affect the Complications Rate? | ||||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||||
| Article 2, Volume 42, Issue 1, January 2018, Page 1-6 PDF (31.63 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejprs.2018.214969 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Khaled Sadek* ; Hatem Elsahar | ||||
| The Department of Plastic Surgery, Faculty of Medicine, Cairo University, Egypt | ||||
| Abstract | ||||
| Background: Minimizing the postoperative complications after reduction mammoplasty is an important goal. Our aim of the study was to compare the complications rate when using drains versus no drains. Methods: The study was conducted in the period from February 2014 to January 2017. We recruited women between 26 to 45 years presenting for reduction mammoplasty with BMI 28-37. All patients subjected to the same preoperative preparations. Operative techniques used were inferior pedicle, superior pedicle, supero-central pedicle and supero-medial pedicle. The only difference between the two groups of the study is the use of drains in one group only. The follow-up < br />period was six weeks. Results: Thirty-one subjects were included in the analysis of this study. Seventeen allocated to the drain group and 14 to the no-drain group. Both groups are comparable as regard the age and BMI (p-value >0.05). However, there was a significant difference between both groups as regard the previous pregnancy with more gravida in the drain’s group. The time of operation in relation to menstrual cycle was comparable in both groups (p-value 0.621) as well as the operative techniques done in both groups (p-value = 0.621). In the drain groups, the average duration of the drain was 10.29+1.77 days. The rate of complication was comparable in both groups (p-value 0.517). The hematoma occurred in two cases, one case in each group. Infection occurred in two cases in the nodrain group. Seroma occurred in four cases, two in each group. However, wound dehiscence in lower T junction occurred only in one case of the drain group. Conclusion: To sum up, we conclude that despite the limited evidence, our study supports the non-use of drains in reduction mammoplasty. However, a further large-sample study is recommended to allow a real evidence and quantification of the risks due to using the drains. | ||||
| Keywords | ||||
| Drains; Reduction mammoplasty; Complications rate | ||||
| References | ||||
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Greco R. and Noone B.: Evidence-Based Medicine: Reduction Mammaplasty. Plastic and Reconstructive Surgery. Volume 139, Number 1, 2017. 2- American Society of Plastic Surgeons: Evidence-based clinical practice guideline: Reduction mammaplasty. Available at: http://www.plasticsurgery.org/Documents/ Health-Policy/Guidelines/guideline-2011-reductionmammaplasty. pdf. Accessed September 1, 2015. 3- Strojkovic C.A., van der Horst C.M. and Kahn S.M.: Wound drainage after plastic and reconstructive surgery of the breast. Cochrane Database Syst. Rev., 3: CD007258. 47, 2013. 4- Collis N., McGuiness C.M. and Batchelor A.G.: Drainage in breast reduction surgery: A prospective randomized intra-patient trial. Br. J. Plast. Surg., 58: 286-289, 2005. 5- Corion L.U., Smeulders M.J., van Zuijlen P.P. and van der Horst C.M.: Draining after breast reduction: A prospective randomized intra-patient study. J. Plast. Recontr. Aesthet. Surg., 62: 865-868, 2009. 6- Wrye S.W., Banducci D.R., Mackay D., Graham W.P. and Hall W.W.: Routine drainage is not required in reduction mammaplasty. Plast. Reconstr. Surg., 111: 113-117, 2003. 7- Iwuagwu O.C., Platt A.J. and Drew P.J.: Breast reduction surgery in the UK and Ireland-current trends. Ann. R. Coll. Surg. Engl., 88: 585-588, 2006. 8- See M.H.: Central pedicle reduction mammoplasty: A reliable technique. Gland Surgery, 3 (1): 51-54. doi: 10.3978/j.issn.2227-684X.2014.02.09, 2014. 9- Ricbourg B.: Applied anatomy of the breast: Blood supply and innervation. Ann. Chir. Plast. Esthet., 37: 603-20, 1992. 10- Würinger E., Mader N., Posch E., et al.: Nerve and vessel supplying ligamentous suspension of the mammary gland. Plast. Reconstr. Surg., 101: 1486-93, 1998. 11- Würinger E.: Refinement of the central pedicle breast reduction by application of the ligamentous suspension. Plast. Reconstr. Surg., 103: 1400-10, 1999. 12- Schlenz I., Rigel S., Schemper M., et al.: Alteration of nipple and areola sensitivity by reduction mammaplasty: A prospective comparison of five techniques. Plast. Reconstr. Surg., 115: 743-51; discussion 752-4, 2005. 13- Cho B.C., Yang J.D. and Baik B.S.: Periareolar reduction mammoplasty using an inferior dermal pedicle or a central pedicle. J. Plast. Reconstr. Aesthet. Surg., 61: 275-81, 2008. 14- Ngan P.G., Iqbal H.J., Jayagopal S., Sillitoe A.T., Dhital S.K. and Juma A.: When to use drains in breast reduction surgery? Ann. Plast. Surg., 63: 135-137, 2009. 15- Carolyn L. Kerrigan and Sheri S. Slezak.: Evidence-Based Medicine: Reduction Mammaplasty. Plast. Reconstr. Surg., 132: 1670. DOI: 10.1097/PRS.0b013e3182a807ec, 2013. 16- Felippe W.A., Werneck G.L. and Santoro-Lopes G.: Surgical site infection among women discharged with a drain in situ after breast cancer surgery. World J. Surg., 31: 2293-2299, 2007. 17- Barton A., Blitz M., Callahan D., et al.: Early removal of postmastectomy drains is not beneficial: Results from a halted randomized controlled trial. Am. J. Surg., 191: 652-656, 2006. 18- Vandeweyer E.: Breast reduction mammaplasty. Shall we drain? Acta. Chir. Belg., 103: 596-598, 2003. 19- Arrowsmith J., Eltigani E., Krarup K., et al.: An audit of breast reduction without drains. Br. J. Plast. Surg., 52: 586-588, 1999. 20- Khan S.M., Smeulders M.J.C. and Van der Horst C.M.: Wound drainage after plastic and reconstructive surgery of the breast. Cochrane Database of Systematic Reviews, Issue 10. Art. No.: CD007258. DOI: 10.1002/14651858. CD007258.pub3, 2015. | ||||
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