Analysis of factors influencing drain amount, time to drain removal, and seroma formation in patients undergoing immediate expander-implant breast reconstruction

Woo, Kyong Je; Paik, Joo Myong; Mun, Goo‐Hyun; Pyon, Jai Kyong; Jeon, Byung Joon; Bang, Sa Ik

doi:10.1080/2000656x.2017.1330208

Cited by 16 publications

(19 citation statements)

References 23 publications

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“…Recent studies have identified larger expander/implant size to be associated with increased reconstructive complications, 31,32 a finding that is in agreement with our data. A likely explanation for the increased complication rate is that larger expanders and implants put added pressure on already attenuated mastectomy skin flaps.…”

Section: Discussionsupporting

confidence: 93%

A Multicenter Analysis Examining Patients Undergoing Conversion of Implant-based Breast Reconstruction to Abdominally based Free Tissue Transfer

Zhao

Tran

Doval

et al. 2018

J reconstr Microsurg

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Background Breast implant placement is the most common method for postmastectomy reconstruction. For patients who develop complications associated with implant-based reconstruction, additional surgeries may be challenging. This study examined implant-based reconstruction failure in patients undergoing salvage with abdominal free tissue transfer. Methods We conducted an Institutional Review Board approved, multicenter retrospective study of patients with implant-based primary breast reconstruction followed by implant removal and subsequent abdominal free tissue transfer between 2006 and 2016. Patient demographics, treatment details, and complications were evaluated. Severity of implant failure was graded as either (1) not severe (delayed salvage reconstruction) or (2) severe (immediate salvage reconstruction). Results Between 2006 and 2016, 115 patients with 180 mastectomy defects underwent primary implant-based reconstruction with subsequent implant removal and abdominally based free tissue reconstruction. Of these, 68 were delayed and 47 were immediate salvage reconstruction. Factors leading to elective removal were capsular contracture, asymmetry, and implant malposition. Factors leading to obligatory removal were infection, delayed wound healing, and implant extrusion. Postmastectomy radiation was significantly associated with immediate salvage reconstruction (p < 0.001, odds ratio = 3.9) as were large volume implants (p = 0.06). Deep inferior epigastric perforator flaps comprised 78.3% of all abdominally based free tissue reconstructions, while muscle-sparing transverse rectus abdominus myocutaneous flaps comprised 18.3%. Overall flap failure rate was 2.6% (2.94% delayed and 2.13% immediate salvage reconstruction; p = 1.0). Conclusion Our findings suggest that abdominal free tissue transfer remains a safe and effective salvage modality for implant-based breast reconstruction failure. Patients with severe implant failure were more likely to have received radiation. Surgeons should remain cognizant of this during care of patients.

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Section: Discussionsupporting

confidence: 93%

A Multicenter Analysis Examining Patients Undergoing Conversion of Implant-based Breast Reconstruction to Abdominally based Free Tissue Transfer

Zhao

Tran

Doval

et al. 2018

J reconstr Microsurg

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“…14 It has been hypothesized that additional synthetic material might lead to a prolonged inflammatory response contributing to a longer drain time. 12 However, this could not be seen in the present material as daily drainage outputs and drain times were similar. Nonetheless, there were more seroma aspirations and significantly more seroma formation present during the exchange to permanent implants.…”

Section: Discussioncontrasting

confidence: 56%

“…This study compares seroma production in implant-based immediate breast reconstruction with a biological mesh with that of a synthetic mesh. Seroma formation is affected by patient-related factors, such as older age, higher BMI, and larger breast size (mastectomy weight), 6,12 by surgical factors, such as the size of TEs used and axillary lymph node dissection, 12,13 and by qualities of the mesh/matrix. The present study compares the right breast with left breast in the same patient, and the operations were performed in the same way, save the mesh/matrix used, in all patients.…”

Section: Discussionmentioning

confidence: 99%

Drain secretion and seroma formation after immediate breast reconstruction with a biological and a synthetic mesh, respectively: A randomized controlled study

2020

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“…The avoidance of repeated aspirations could also help prevent additional unnecessary physical and psychological trauma and aspiration-related wound infection. [161718] Despite the promising results, however, this study was limited because it was a non-randomized retrospective study with a small sample. Detection and selection biases could not be avoided completely.…”

Section: Discussionmentioning

confidence: 99%

Natural History of Seroma Following the Immediate Latissimus Dorsi Flap Method of Breast Reconstruction

Yan

Mang

Ren

et al. 2018

Chinese Medical Journal

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Background:The latissimus dorsi (LD) flap procedure remains a popular and useful breast reconstruction tool in China and Western countries, and donor site seroma formation is the main complication. This study was conducted in Chinese patients to determine whether stable cases of seromas would resolve without treatment.Methods:A retrospective review of 45 consecutive cases of immediate breast reconstruction with LD flap from April 2012 to February 2017 was conducted. The scope of the seroma was demarcated with a marker pen, and cases that remained stable over time (i.e. the size of the seroma did not increase) were observed without treatment. The measured outcomes included the incidence of seromas, the volume and duration of postoperative wound drainage, and other demographic characteristics.Results:Twenty-four patients (53.3%) developed a seroma at the donor site. Of these, 21 patients (87.5%) did not require treatment, and the seroma resolved over time. The mean duration of a sustained seroma was 6.8 ± 1.4 weeks (range: 4–9 weeks).Conclusions:This study observed the scope and progression of the seromas and found that seromas at the LD donor sites resolved over time without treatment.

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Analysis of factors influencing drain amount, time to drain removal, and seroma formation in patients undergoing immediate expander-implant breast reconstruction

Abstract: The use of ADM and initial inflation ratio do not influence days to drain removal or seroma formation. A longer period of drain placement is expected when a larger expander is used or in elderly patients.

Cited by 16 publications

References 23 publications

A Multicenter Analysis Examining Patients Undergoing Conversion of Implant-based Breast Reconstruction to Abdominally based Free Tissue Transfer

A Multicenter Analysis Examining Patients Undergoing Conversion of Implant-based Breast Reconstruction to Abdominally based Free Tissue Transfer

Drain secretion and seroma formation after immediate breast reconstruction with a biological and a synthetic mesh, respectively: A randomized controlled study

Natural History of Seroma Following the Immediate Latissimus Dorsi Flap Method of Breast Reconstruction

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