The drain game: Abdominal drains for transverse rectus abdominis myocutaneous breast reconstruction.

Abstract

INTRODUCTION We recently published data for the duration of donor site drain use in latissimus dorsi and deep inferior epigastric perforator breast reconstruction, due to a reported requirement in the literature; evidence is still required for transverse rectus abdominis myocutaneous (TRAM) reconstruction. AIM To compare inpatient hospital stay, drainage parameters and donor-site complications associated with closed suction abdominal drain removal by post-operative day (POD) 3 regardless of output (early group), versus after POD 3 where instructions were by drainage volume/24 h ± output consistency (late group), in post-mastectomy TRAM breast reconstruction. METHOD A retrospective review of TRAM breast reconstructions, between June 2008-2013, was undertaken with a minimum 1 year follow-up per patient. RESULTS Of 65 patients who underwent TRAM breast reconstruction, 56 hospital records contained complete documentation. Both the late (n = 35) and early (n = 21) drain removal group were matched for age and number of donor site drains (2 per patient). Mean drain removal day (5.34 ± 0.20 days vs. 2.67 ± 0.14 days; p < 0.0001), total drainage (797.86 ± 77.15 mls vs. 295.71 ± 29.72 mls; p < 0.0001) and hospital inpatient stay (7.46 ± 0.29 days vs. 6.09 ± 0.32 days; p = 0.003) were greater for patients in the late versus early group. There were no differences in total complications (5.71% (2/35) vs. 14.29% (3/21); p = 0.28), including seroma (2.86% (1/35) vs. 4.76% (1/21); p = 0.71) rates between the late and early groups. DISCUSSION These data suggest significant advantages for patients who have abdominal drains removed early by POD 3, without increased post-operative complications including seroma rates; these data are in keeping with our LD data. We recommend drain removal by POD 3.

DOI: 10.1016/j.bjps.2015.02.025

Cite this paper

@article{Miranda2015TheDG, title={The drain game: Abdominal drains for transverse rectus abdominis myocutaneous breast reconstruction.}, author={Benjamin H. Miranda and Robertb Wilson and Kunal Amin and Jagdeep S Chana}, journal={Journal of plastic, reconstructive & aesthetic surgery : JPRAS}, year={2015}, volume={68 6}, pages={810-4} }