title: The effect of closed-suction drains on the incidence of local wound complications following tissue expander/implant reconstruction: a cohort study.
abstract: BACKGROUND
  The purpose of this investigation was to evaluate the effect of drains on complications, including infection, seroma, and hematoma formation, in patients undergoing exchange of a temporary expander for a permanent breast implant.
  
  
  METHODS
  A review of all tissue expander/implant breast reconstructions performed at a single center from 1997 to 2004 was undertaken. Two patient cohorts were identified: patients who underwent exchange of their expander to a permanent implant with the use of closed-suction drains and patients who underwent the exchange procedure without the use of drains. The incidence of infection, seroma, and hematoma formation was determined for each cohort. Chi-square and two-sample t tests were performed for categorical and continuous variables, respectively.
  
  
  RESULTS
  A total of 2446 exchange procedures in 1863 patients were performed. In 1495 reconstructions (1165 patients), drains were placed after the exchange procedure; in 951 reconstructions (698 patients), no drains were used. There was no difference in the overall rate of complications following the exchange procedure with or without the use of drains (p = 0.886). Specifically, there was no difference in the incidence of infection necessitating implant removal in the presence of drains compared with that in the absence of drains (p = 0.585). Similarly, there was no significant difference in the rate of hematoma/seroma formation with or without the use of drains (p = 0.742).
  
  
  CONCLUSIONS
  The use of periprosthetic, closed-suction drains after exchange of a temporary expander for a permanent breast implant does not affect the incidence of perioperative complications, including infection, seroma, and hematoma formation.
authors.affiliation: New York, N.Y. From the Memorial Sloan-Kettering Cancer Center.
authors.forename: Colleen M
authors.initials: CM
authors.lastname: McCarthy
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Disa
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Pusic
authors.forename: Babak J
authors.initials: BJ
authors.lastname: Mehrara
authors.forename: Peter G
authors.initials: PG
authors.lastname: Cordeiro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006406:Hematoma / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D016462:Mammaplasty / Q000009:adverse effects* / Q000295:instrumentation; D008875:Middle Aged; D012189:Retrospective Studies; D049291:Seroma / Q000453:epidemiology / Q000209:etiology; D013396:Suction; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology; D015625:Tissue Expansion Devices