The Use of Postoperative Drains Versus No Drains in Reduction Mammoplasty: Does it Affect the Complications Rate?

Document Type : Original Article

Authors

The Department of Plastic Surgery, Faculty of Medicine, Cairo University, Egypt

Abstract

Background: Minimizing the postoperative complications
after reduction mammoplasty is an important goal. Our aim
of the study was to compare the complications rate when
using drains versus no drains.
Methods: The study was conducted in the period from
February 2014 to January 2017. We recruited women between
26 to 45 years presenting for reduction mammoplasty with
BMI 28-37. All patients subjected to the same preoperative
preparations. Operative techniques used were inferior pedicle,
superior pedicle, supero-central pedicle and supero-medial
pedicle. The only difference between the two groups of the
study is the use of drains in one group only. The follow-up < br />period was six weeks.
Results: Thirty-one subjects were included in the analysis
of this study. Seventeen allocated to the drain group and 14
to the no-drain group. Both groups are comparable as regard
the age and BMI (p-value >0.05). However, there was a
significant difference between both groups as regard the
previous pregnancy with more gravida in the drain’s group.
The time of operation in relation to menstrual cycle was
comparable in both groups (p-value 0.621) as well as the
operative techniques done in both groups (p-value = 0.621).
In the drain groups, the average duration of the drain was
10.29+1.77 days.
The rate of complication was comparable in both groups
(p-value 0.517). The hematoma occurred in two cases, one
case in each group. Infection occurred in two cases in the nodrain
group. Seroma occurred in four cases, two in each group.
However, wound dehiscence in lower T junction occurred
only in one case of the drain group.
Conclusion: To sum up, we conclude that despite the
limited evidence, our study supports the non-use of drains in
reduction mammoplasty. However, a further large-sample
study is recommended to allow a real evidence and quantification
of the risks due to using the drains.

Keywords

Main Subjects

References

Greco R. and Noone B.: Evidence-Based Medicine: Reduction
Mammaplasty. Plastic and Reconstructive Surgery.
Volume 139, Number 1, 2017.
2- American Society of Plastic Surgeons: Evidence-based
clinical practice guideline: Reduction mammaplasty.
Available at: http://www.plasticsurgery.org/Documents/
Health-Policy/Guidelines/guideline-2011-reductionmammaplasty.
pdf. Accessed September 1, 2015.
3- Strojkovic C.A., van der Horst C.M. and Kahn S.M.:
Wound drainage after plastic and reconstructive surgery
of the breast. Cochrane Database Syst. Rev., 3: CD007258.
47, 2013.
4- Collis N., McGuiness C.M. and Batchelor A.G.: Drainage
in breast reduction surgery: A prospective randomized
intra-patient trial. Br. J. Plast. Surg., 58: 286-289, 2005.
5- Corion L.U., Smeulders M.J., van Zuijlen P.P. and van
der Horst C.M.: Draining after breast reduction: A prospective
randomized intra-patient study. J. Plast. Recontr.
Aesthet. Surg., 62: 865-868, 2009.
6- Wrye S.W., Banducci D.R., Mackay D., Graham W.P. and
Hall W.W.: Routine drainage is not required in reduction
mammaplasty. Plast. Reconstr. Surg., 111: 113-117, 2003.
7- Iwuagwu O.C., Platt A.J. and Drew P.J.: Breast reduction
surgery in the UK and Ireland-current trends. Ann. R.
Coll. Surg. Engl., 88: 585-588, 2006.
8- See M.H.: Central pedicle reduction mammoplasty: A
reliable technique. Gland Surgery, 3 (1): 51-54. doi:
10.3978/j.issn.2227-684X.2014.02.09, 2014.
9- Ricbourg B.: Applied anatomy of the breast: Blood supply
and innervation. Ann. Chir. Plast. Esthet., 37: 603-20,
1992.
10- Würinger E., Mader N., Posch E., et al.: Nerve and vessel
supplying ligamentous suspension of the mammary gland.
Plast. Reconstr. Surg., 101: 1486-93, 1998.
11- Würinger E.: Refinement of the central pedicle breast
reduction by application of the ligamentous suspension.
Plast. Reconstr. Surg., 103: 1400-10, 1999.
12- Schlenz I., Rigel S., Schemper M., et al.: Alteration of
nipple and areola sensitivity by reduction mammaplasty:
A prospective comparison of five techniques. Plast. Reconstr.
Surg., 115: 743-51; discussion 752-4, 2005.
13- Cho B.C., Yang J.D. and Baik B.S.: Periareolar reduction
mammoplasty using an inferior dermal pedicle or a central
pedicle. J. Plast. Reconstr. Aesthet. Surg., 61: 275-81,
2008.
14- Ngan P.G., Iqbal H.J., Jayagopal S., Sillitoe A.T., Dhital
S.K. and Juma A.: When to use drains in breast reduction
surgery? Ann. Plast. Surg., 63: 135-137, 2009.
15- Carolyn L. Kerrigan and Sheri S. Slezak.: Evidence-Based
Medicine: Reduction Mammaplasty. Plast. Reconstr. Surg.,
132: 1670. DOI: 10.1097/PRS.0b013e3182a807ec, 2013.
16- Felippe W.A., Werneck G.L. and Santoro-Lopes G.:
Surgical site infection among women discharged with a
drain in situ after breast cancer surgery. World J. Surg.,
31: 2293-2299, 2007.
17- Barton A., Blitz M., Callahan D., et al.: Early removal of
postmastectomy drains is not beneficial: Results from a
halted randomized controlled trial. Am. J. Surg., 191:
652-656, 2006.
18- Vandeweyer E.: Breast reduction mammaplasty. Shall we
drain? Acta. Chir. Belg., 103: 596-598, 2003.
19- Arrowsmith J., Eltigani E., Krarup K., et al.: An audit of
breast reduction without drains. Br. J. Plast. Surg., 52:
586-588, 1999.
20- Khan S.M., Smeulders M.J.C. and Van der Horst C.M.:
Wound drainage after plastic and reconstructive surgery
of the breast. Cochrane Database of Systematic Reviews,
Issue 10. Art. No.: CD007258. DOI: 10.1002/14651858.
CD007258.pub3, 2015.

Files

Share

How to cite

Statistics