Short versus long-term postoperative drainage of the axilla after axillary lymph node dissection. A prospective randomized study.
BACKGROUND
Axillary lymph node dissection (ALND) is a standard procedure in the treatment of breast cancer. Current practice following ALND involves several days of drainage of the axilla to reduce the formation of seroma. The aim of this study is to investigate the feasibility of 24 h drainage.


METHODS
A prospective randomized trial was performed comparing 24 h drainage to long-term drainage. The primary outcome measure was duration of hospital stay. Formation of seroma and wound related complications were secondary outcome measures.


RESULTS
Fifty patients were randomised to the 24 h drainage group and 50 patients to the long-term drainage group. 24 h drainage was associated with a shorter hospital stay (2.5 versus 4.6 days, p < 0.001). Seroma aspiration was required in 76% of the patients after 24 h drainage and in 64% after long-term drainage (p = 0.19). The number of wound related complications was higher after long-term drainage (13 versus 9, p = 0.33). Infectious complications were seen in 11 patients after long-term drainage versus 6 after 24 h drainage (p = 0.18).


CONCLUSIONS
These results indicate that 24 h drainage following ALND is feasible and facilitates early hospital discharge. Furthermore, 24 h drainage is not associated with excess wound related complications compared to long-term drainage.
Baas-Vrancken Peeters
Marie-Jeanne T F D
MJ
Department of Surgery, Haga Hospital, The Hague, The Netherlands. m.j.baas@amc.uva.nl
Kluit
Ariane B
AB
Merkus
Jos W S
JW
Breslau
Paul J
PJ
D001365:Axilla; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008197:Lymph Node Excision; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D049291:Seroma / Q000453:epidemiology / Q000517:prevention & control*; D013396:Suction / Q000295:instrumentation / Q000379:methods*; D013530:Surgical Wound Infection / Q000453:epidemiology; D013997:Time Factors