Postoperative Showering for Patients With Closed Suction Drainage: A Retrospective Cohort Study of Deep Inferior Epigastric Perforator Flap Breast Reconstructions

Abstract

Background The deep inferior epigastric perforator (DIEP) flap has been widely used in breast reconstruction. During surgery, many surgeons use closed suction drainage for both the donor site and the reconstructed breast. However, the criteria for drainage removal depend on the surgeon’s preference and remain controversial. Moreover, it is well known that early postoperative showering is harmless to the surgical site and is recommended in many reports. However, it has not been discussed whether it is acceptable for patients with closed suction drainage to take a shower. Methodology We conducted a retrospective study of postoperative showering in 30 patients who underwent breast reconstruction with a DIEP flap. During the surgery, a total of three closed suction drains were connected to the patient’s body (one was connected to the reconstructed breast, and the other two were connected to the abdominal donor site). After the surgery, patients were allowed to shower when the number of connected drainage tubes was ≤2. Results The patients were divided into three groups according to the number of remaining drainage tubes connected to their bodies when they started postoperative showering. Group A included patients with no drainage tubes. Group B included patients with one remaining drainage tube. Group C included patients with two drainage tubes. No significant differences in the incidence of postoperative individual complications were observed among the three groups. Conclusions Postoperative showering for patients with closed suction drainage is safe and does not increase the incidence of postoperative complications, including surgical site infection.

Elective surgery and postoperative shower: mind the gap and push the limits

“…Therefore, the removal of devices that create communication between internal organs or cavities and the external environment appears as a safe limit for early postoperative showering. This notion has been recently challenged by a study in patients undergoing breast surgery, where Ogawa et al [2022] showed no increased risk for complications when patients with closed suction drains showered (7). The safety trade-off in this study was two or less connected tubes, either to the abdominal donor site or to the reconstructed breast (7).…”

“…This notion has been recently challenged by a study in patients undergoing breast surgery, where Ogawa et al [2022] showed no increased risk for complications when patients with closed suction drains showered (7). The safety trade-off in this study was two or less connected tubes, either to the abdominal donor site or to the reconstructed breast (7). Although, a head-to-head comparison with cardiac surgery is not feasible, this study leaves room for evaluating showering in patients with a limited number of closed drain tubes.…”