title: Superior pedicle breast reduction techniques increase the risk of postoperative drainage.
abstract: BACKGROUND
  The most frequent complication after bilateral reduction mammoplasty (BRM) is the formation of seromas and hematomas. If a group of patients who are at increased risk of seroma and hematoma are identified, the use of drains in this group would be beneficial. We hypothesized that superior pedicle reductions would have increased postoperative drainage.
  
  
  METHODS
  A prospective observational study was conducted to identify independent risk factors for increased drainage after BRM. Blinded research nurses were employed to record the amount of drainage during the postoperative period. Univariate and multivariate regression analyses were used to identify risk factors for increased postoperative drainage.
  
  
  RESULTS
  The study included a total of 111 patients. Univariate analysis identified the amount of preoperative infiltration (P < 0.001), the amount of liposuction (P < 0.001), the amount of surgically resected tissue (P = 0.001), the type of reduction (P < 0.001), the patient's chest circumference (P = 0.035), and the patient's body mass index (BMI) (P = 0.015) as significant predictors of postoperative drainage. Multivariate regression analysis identified the amount of tissue resected and the type of reduction as the only 2 independent predictors of postoperative drainage. The use of superior pedicle technique predicted 43% of the variability in postoperative wound drainage.
  
  
  CONCLUSIONS
  The use of the superior pedicle technique for BRM is associated with a significant increase in postoperative drainage. Surgeons using this technique should consider the routine use of drains to avoid possible complications of seroma, infection, and poor wound healing.
authors: Division of Plastic and Reconstructive Surgery, Epidemiology Coordinating and Research Centre, University of Alberta, Edmonton, Alberta, Canada. aanzarut@ualberta.ca
authors: Alexander
authors: A
authors: Anzarut
authors: David C
authors: DC
authors: Edwards
authors: Kevin
authors: K
authors: Calder
authors: Craig R
authors: CR
authors: Guenther
authors: Ross
authors: R
authors: Tsuyuki
mesh_terms: D000328:Adult; D005260:Female; D006406:Hematoma / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects* / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012307:Risk Factors; D049291:Seroma / Q000453:epidemiology* / Q000517:prevention & control