Randomized clinical trial of no wound drains and early discharge in the treatment of women with breast cancer.
BACKGROUND
Women undergoing surgery for primary breast cancer routinely have suction drains inserted deep to the wounds, which are removed approximately 6-8 days after operation, requiring a period of stay of that duration in hospital. The aim of this study was to perform a prospective randomized clinical trial to evaluate a new surgical technique of suturing flaps without wound drainage, combined with early discharge, in women undergoing surgery for breast cancer.


METHODS
A total of 375 patients undergoing surgery for breast cancer were randomized to conventional surgery or suturing of flaps with no drain. The main outcome measures were length of hospital stay, surgical morbidity, psychological morbidity and health economics.


RESULTS
Suturing of flaps and avoiding wound drainage in women undergoing surgery for breast cancer resulted in a significantly shorter hospital stay. Adopting this surgical technique with early discharge did not lead to any difference in surgical or psychological morbidity. Health economic benefits to the National Health Service resulted from saved bed days with no impact on community costs.


CONCLUSIONS
Wound drainage following surgery for breast cancer can be avoided, thereby facilitating early discharge with no associated increase in surgical or psychological morbidity.
Purushotham
A D
AD
Department of Surgery, Western Infirmary, University of Edinburgh, Edinburgh, UK. amy.byrtus@addenbrookes.nhs.uk
McLatchie
E
E
Young
D
D
George
W D
WD
Stallard
S
S
Doughty
J
J
Brown
D C
DC
Farish
C
C
Walker
A
A
Millar
K
K
Murray
G
G
D001509:Bed Occupancy; D001943:Breast Neoplasms / Q000191:economics / Q000523:psychology / Q000601:surgery*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007902:Length of Stay; D008408:Mastectomy / Q000191:economics / Q000379:methods*; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D010351:Patient Discharge; D011182:Postoperative Care / Q000191:economics; D011446:Prospective Studies; D012785:Shoulder Joint; D013396:Suction / Q000191:economics; D013524:Surgical Flaps / Q000191:economics; D013536:Suture Techniques / Q000191:economics