When to Use Drains in Breast Reduction Surgery?

Ngan, P.G.; Iqbal, Hafiz Javaid; Jayagopal, Sathish; Sillitoe, Anthony T.; Dhital, Sanjiv K.; Juma, Ali

doi:10.1097/sap.0b013e3181893809

Cited by 17 publications

(8 citation statements)

References 21 publications

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“…Reduction mammaplasties in which NAC repositioning and skin excision are done without drains have been demonstrated to be safe, without increased complications. [30][31][32][33] Additionally, the pain and discomfort associated with wound drainage are avoided, and nursing time involved with drain care is minimized.…”

Section: Discussionmentioning

confidence: 99%

Necessity of Suction Drains in Gynecomastia Surgery

Keskin

Sütçü

Cigsar

et al. 2014

Aesthetic Surgery Journal

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Section: Discussionmentioning

confidence: 99%

Necessity of Suction Drains in Gynecomastia Surgery

Keskin

Sütçü

Cigsar

et al. 2014

Aesthetic Surgery Journal

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“…Although this arbitrary level has some variation between plastic surgery units, it is common for drains to be removed at ≤30 ml/24 h, and a recent study found that for breast reduction in the UK, only 7.5% did not use this level [2]. This has been the level used in a number of studies assessing the need for drain usage in breast reduction despite the fact that there is no evidence for this practice [7]. Another recent study used ≤20 ml/24 h as the cutoff level for drain removal in breast reduction surgery; again, there was no evidence provided for this rationale [8].…”

Section: Discussionmentioning

confidence: 93%

The timing of drain removal—empiricism or science?

2011

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Surgical drains are commonly used in plastic surgery. Drains are subsequently removed at arbitrary volumes depending on local protocols. The rational for when to remove a drain has not been scientifically determined. We compared removal of drains at ≤30 ml/24 h vs. ≤50 ml/24 h for 158 wounds, in 90 patients. Postoperative complications, length of hospital stay and resulting cost-benefit were considered. Prospective data were collected for two consecutive similar cohorts of patients undergoing abdominoplasty, bilateral breast reduction and breast augmentation. In the first cohort, drains were removed when drainage was ≤30 ml/24 h and the second cohort when ≤50 ml/24 h. Demographics, days of drainage, surgeon grade and duration of postoperative hospital stay were recorded. Patient records were then analysed and complications recorded, including haematoma, infection, seroma, wound breakdown and fat necrosis. The median postoperative stay for all three operations for both drainage cohorts was similar with no statistically significant difference; however, the drainage time in breast augmentation was significantly less in the <50 ml/24 h group. There were no significant differences in outcome measures between the patients undergoing abdominoplasty, breast reduction or breast augmentation. Drain removal at ≤50 vs. ≤30 ml/24 h did not result in an increase in postoperative morbidity or adverse outcome in any of the three different operation types.

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“…[12][13][14] Similarly, a prospective study conducted by Collis et al 4 on 150 patients was unsuccessful in demonstrating the positive effects of drain usage on hematoma and wound healing, and the authors, referring to Halsted's words from 1893, remarked that "[it is] better not to apply drainage at all than to apply unknowingly. " On the other hand, recommending the utilization of drains in selected breast reduction procedures, Ngan et al 15 have defined these cases as young patients and cases in which less than 500 g is resected. In another study conducted by Borile et al 16 on abdominal dermolipectomy patients, no statistically significant differences were found with respect to hematoma or seroma formation between the two groups in which drains and abdominal corsets were used.…”

Section: Discussionmentioning

confidence: 99%

“…[17][18][19][20] Numerous publications are available in the literature that compare the efficacy of drainage systems by the types of procedure. 4,[10][11][12][13][14][15][16][17][18][19][20] Moreover, how efficient drains function in the postoperative period, regardless of the surgical procedure type, is another topic that is yet to be studied. No studies are available in the literature about the impact of the type and the size of the drain on its efficacy.…”

Section: Discussionmentioning

confidence: 99%

“…In previously conducted studies, drain efficacy was assessed in patient groups that had undergone a specific surgical procedure such as facelift, breast reduction or abdominoplasty. [10][11][12][13][14][15][16][17][18][19][20] In this study, the efficacy of a selected type of drain was assessed in patient groups that have been operated on by the same surgical team for diverse surgical procedures.…”

Section: Discussionmentioning

confidence: 99%

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Drains and Drainage Capabilities: Quantitative Analysis of Drain Efficiencies

Aykan¹,

Güzey²,

Şahin³

et al. 2016

Turk J Plast Surg

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Objective: In this study, it was aimed to compare the efficiency of the same type of but different-sized silicone drains at different surgical procedures. Material and Methods: Twenty-four patients, who had different diagnoses and were operated between 2011 and 2013, were included. In all patients, 7-and 10-mm silicone-ended, Jackson-Pratt drains were used. Drains that were under 30 cc/day removed. The connection tube and perforated silicone end were examined due to the clot content. All drain efficiencies were calculated, and the results were statistically analyzed. Results: Seven of the 24 patients (29.2%) were males and 17 (70.8%) were females; the mean age was 39.0±11.4 years. Totally, 49 drains were used, of which 25 (51%) were 7 mm and 24 (49%) were 10 mm in size. Median removal time was the 5 th day (2-12) for the 7-mm drains and the 6 th day (3-14) for the 10-mm drains. There was no statistically significant difference between the groups for drain removal time (p=0.268). Further, there was no difference at the connection tube and silicone end for clot content between the 7-and 10-mm drains (p=0.58). For the drainage volume and efficiency, no difference was observed between the groups (p=0.146). Conclusion: In this study it was observed that there is no difference in the drainage volume and efficiency between different-sized Jackson-Pratt drains.

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When to Use Drains in Breast Reduction Surgery?

Cited by 17 publications

References 21 publications

Necessity of Suction Drains in Gynecomastia Surgery

Necessity of Suction Drains in Gynecomastia Surgery

The timing of drain removal—empiricism or science?

Drains and Drainage Capabilities: Quantitative Analysis of Drain Efficiencies

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