Wound drainage after axillary dissection for carcinoma of the breast

Thomson, David R.; Sadideen, Hazim; Furniss, Dominic

doi:10.1002/14651858.cd006823.pub2

Cited by 41 publications

(52 citation statements)

References 26 publications

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“…It has been suggested that suction drainage markedly decreased the development of postsurgical seroma (10). Furthermore, it has been reported that nearly all of the total seroma formation was drained within the 48 hours of the post-operative period (1,9). Interestingly, the levels of seroma showed wide variation between the trials.…”

Section: Discussionmentioning

confidence: 99%

“…Axillary dissection is related to the formation of postoperative seroma (33). The development of a seroma has been reported in 10% to 52% of cases (9,34). If a great number of lymph nodes were dissected from the axilla, much more seromas were observed.…”

Section: Discussionmentioning

confidence: 99%

“…Drain removal protocols vary enormously from hospital to hospital, even from department to department in the same hospital. Prolonged drainage may prolong hospital stay (9). Some patients refuse to be discharged with drains, because there are difficulties in managing them at home, which may result in wound infection.…”

Section: Introductionmentioning

confidence: 99%

“…Some patients refuse to be discharged with drains, because there are difficulties in managing them at home, which may result in wound infection. Early removal of drains has been linked with shorter length of hospital stay (LOS) (9)(10)(11). However, indiscriminate withdrawal of drains, regardless of the fluid volume of fluid drained, may be accompanied by increased seroma formation (9,(11)(12)(13)(14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, repeated aspirations and even surgical draining may be required. Furthermore, the risk of infection, skin flap necrosis, prolonged hospital stay, and delay in the commencement of chemotherapy or radiotherapy, or both in some cases, are often increased if drains are not used (9,11).…”

Section: Introductionmentioning

confidence: 99%

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Factors that Affect Drain Indwelling Time after Breast Cancer Surgery

et al. 2016

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Objective:The most common procedure to prevent seroma formation, a common complication after breast and axillary surgery, is to use prophylactic surgical drains. Ongoing discussions continue regarding the ideal time for removing drains after surgical procedures. In this study, we aimed to investigate factors that affect drain indwelling time (DIT). Materials and Methods: From 2014 to 2015, a total of 91 consecutive patients with breast cancer were included in the study. The demographic characteristics of the patients, treatment methods, histopathologic features of the tumor, size of removed breast tissue (BS), tumor size (TS), number of totally removed lymph nodes (TLN), and metastatic lymph nodes (MLN), whether they had neoadjuvant chemotherapy, and the DIT were retrospectively recorded from the hospital database. Results: The mean age of the patients was 48.9 years, and the mean DIT was 4.8 days. The mean size of breast removed was 17.3 cm and tumor size was 4.7 cm, and the mean number of metastatic lymph nodes was 3.3, and mean total number of lymph nodes was 14.1. Patients who had neoadjuvant chemotherahpy had longer DIT. There was a positive correlation between the BS, TS, TLN, MLN, length of hospital stay, and DIT. Linear regresion analysis revealed that the BS, TLN, and history of neoadjuvant chemotherahpy were independent risk factors for DIT. Conclusion: DIT primarily depends on BS, TLN, and history of neoadjuvant chemotherahpy. A policy for the management of removing drains to prevent seroma formation should thus be individualized.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors that Affect Drain Indwelling Time after Breast Cancer Surgery

et al. 2016

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The effect of immediate lymphatic reconstruction on the post‐operative drain output after axillary lymph node dissection for breast cancer: A retrospective comparative study

et al. 2023

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IntroductionAxillary lymph node dissection (ALND) for breast cancer has been considered to be associated with a variety of complications, such as excessive postoperative wound drainage, prolonged drain placement, or seroma formation in the short term, or arm lymphedema in the long run. Immediate lymphedema reconstruction (ILR) has been proposed to reduce the occurrence of arm lymphedema by anastomosing the transected arm lymphatics to nearby branches of the axillary vein immediately after ALND. This study aims to demonstrate that ILR can also reduce the postoperative drainage amount.Patients and MethodsBetween April 2020 and January 2022, a total of 76 breast cancer patients receiving ALND were reviewed. Forty four of them also received ILR immediately after ALND. The assignment of ILR surgery was non‐random, based on patients' willingness and plastic surgeons' availability. The lymphatic vessels in the axillary wound were anastomosed with nearby terminal branches of the axillary vein under surgical microscope. Patients' characteristics, including age, body mass index (BMI), neoadjuvant therapy, type of breast surgery, the occurrence of seroma formation, number of removed lymph nodes, number of positive nodes, and the drainage amount from the operative wounds were compared between ILR and non‐ILR groups.ResultsNo statistically significant difference was noted between groups in terms of age (56.5 ± 9.8 vs. 60.9 ± 10.7, p = .09), BMI (22.6 ± 3.7 vs. 23.7 ± 3.8, p = .27), type of breast surgery (p = .32), the occurrence of seroma formation (p = 1.0), the likelihood of receiving neoadjuvant therapy (p = .12), number of lymph nodes removed (17.5 ± 7.6 vs. 17.4 ± 8.3, p = .96), or number of positive nodes on final pathology (3.7 ± 5.4 vs. 4.8 ± 8.5, p = .53) except the ILR group had statistically significantly less drainage amount than non‐ILR group (39.3 ± 2.6 vs. 48.3 ± 3.7, p = .046).ConclusionFor breast cancer patients receiving ALND, the immediate lymphatic reconstruction can reduce the postoperative drainage amount from the operative wound.

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Immediate Patient Care After Surgery

Karayurt

2021

Breast Cancer Essentials

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Wound drainage after axillary dissection for carcinoma of the breast

Cited by 41 publications

References 26 publications

Factors that Affect Drain Indwelling Time after Breast Cancer Surgery

Factors that Affect Drain Indwelling Time after Breast Cancer Surgery

The effect of immediate lymphatic reconstruction on the post‐operative drain output after axillary lymph node dissection for breast cancer: A retrospective comparative study

Immediate Patient Care After Surgery

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