Perceptions of Surgical Drains among Breast Reconstruction Patients and Health Care Staff: A Qualitative Survey Study

Abstract

BACKGROUND: Surgical drains are a key component for recovery in breast reconstruction procedures. However, they are often cumbersome and carry a risk for infection with prolonged use. Our aim was to develop a more thorough understanding of patient and health care provider perspectives on surgical drains, to inform future efforts in improving the breast reconstruction patient experience. METHODS: Twenty-nine breast reconstruction patients and eight plastic surgery providers were recruited to complete surveys focused on surgical drains. Likert scales ranging from 1-5 were developed to gauge how bothersome drains felt, as well as concern for infection. Ordinal variable and categorical multiple-choice analyses were applied as appropriate. RESULTS: Fifteen (51.7%) patients underwent implant-based breast reconstruction, and 14 (48.3%) patients underwent autologous breast reconstruction. The most common duration of drain placement was two weeks (N=13). The surgical site infection rate requiring antibiotics was 28% (N=8). On a scale of 1-5, both patients (median = 3) and providers (median = 2.5) viewed drains as bothersome. Patients were “frequently” concerned about infection risk (median = 3). Other high-frequency patient concerns included general pain and discomfort. CONCLUSIONS: Surgical drains are a common component of breast reconstruction procedures and are viewed as cumbersome by both patients and providers. Patients expressed concerns about drain site pain, discomfort, and tugging on clothing. Patients and providers both believed that drains could contribute to surgical site infection. Overall, this data provides insight to drive future improvements in the patient drain experience.