title: A prospective randomized trial of high versus low vacuum drainage after axillary dissection for breast cancer.
abstract: METHODS
  The influence of negative pressure on fluid production and complication rates after axillary dissection for breast cancer was studied in a prospective randomized trial. Patients were randomized for either a high or a low vacuum drainage system. Drainage volumes and complication rates were recorded.
  
  
  RESULTS
  No statistically significant differences were found between the low vacuum group (n = 68) and the high vacuum group (n = 73) in volume (728 ml versus 780 ml) and duration (9.5 days versus 10 days) of seroma production, number of wound complications (5 versus 6), or infections (3 versus 2). There was a significant positive relationship between body mass index and seroma production, independent of the drainage system (P = 0.002). The drainage volume of the separately drained breast wound after mastectomy and lumpectomy was larger for the high vacuum system (55 ml versus 100 ml, P = 0.02). Vacuum loss was more frequent in the high vacuum drain group (11 versus 2, P = 0.01), where as leakage around the drain occurred more often in the low vacuum group (18 versus 6, P = 0.004).
  
  
  CONCLUSIONS
  There are no differences in axillary fluid production or wound complication rates after axillary dissection and subsequent drainage between high and low vacuum drainage systems.
authors.affiliation: Department of Surgical Oncology, University Hospital Rotterdam/Daniel den Hoed Cancer Center, Rotterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Bonnema
authors.forename: A N
authors.initials: AN
authors.lastname: van Geel
authors.forename: D A
authors.initials: DA
authors.lastname: Ligtenstein
authors.forename: P I
authors.initials: PI
authors.lastname: Schmitz
authors.forename: T
authors.initials: T
authors.lastname: Wiggers
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla / Q000601:surgery; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000601:surgery*; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D004868:Equipment Failure; D005260:Female; D006801:Humans; D015994:Incidence; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D015411:Mastectomy, Modified Radical; D015412:Mastectomy, Segmental; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D014618:Vacuum