The effect of closed-suction drains on the incidence of local wound complications following tissue expander/implant reconstruction: a cohort study.
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.
McCarthy
Colleen M
CM
New York, N.Y. From the Memorial Sloan-Kettering Cancer Center.
Disa
Joseph J
JJ
Pusic
Andrea L
AL
Mehrara
Babak J
BJ
Cordeiro
Peter G
PG
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