title: Early removal of drains and the incidence of seroma after breast surgery.
abstract: BACKGROUND
  Women undergoing surgery for primary breast cancer routinely have suction drains inserted deep to the wounds. A lack of data exists in relating how long suction drains should stay in situ after major breast surgery.
  
  
  OBJECTIVE
  This study evaluates the appropriate timing of drain removal by comparing the 5-day-long postoperative drainage or drain removal when less than 50 mL/24 h to conventional drain removal.
  
  
  METHODS
  This controlled clinical trial was undertaken between February 1997 and May 2012 with a total of 214 consecutive patients who underwent elective total or partial mastectomy with level II axillary lymph node dissection. The main outcome measures included the length of hospital stay, and surgical morbidity, especially seroma formation.
  
  
  RESULTS
  In the study group, the age and operation time were significantly increased compared to the conventional group whereas the median hospital stay was significantly shorter in the study group than the control group (7 days vs. 9 days; p < 0.05). The incidence of seroma was 42.8 % in the study group and 31.6 % in the control group (p = 0.14). The mean number of outpatient visits for seroma was 3.6 in the study group and 1.5 in the control group (p < 0.05). Drainage volume of more than 150 mL/24 h all resulted in seroma formation.
  
  
  CONCLUSIONS
  The new criteria for early drain removal are safe and acceptable despite the slightly increased chance of seroma formation.
authors.affiliation: Department of Surgery, Teine Keijinkai Hospital, 1-12 Maeda, Teine-ku, Sapporo, 006-8555, Japan, o_naoya_o@me.com.
authors.forename: Naoya
authors.initials: N
authors.lastname: Okada
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Narita
authors.forename: Minoru
authors.initials: M
authors.lastname: Takada
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kato
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Ambo
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Nakamura
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kishida
authors.forename: Nobuichi
authors.initials: N
authors.lastname: Kashimura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000601:surgery*; D020878:Device Removal / Q000009:adverse effects*; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008197:Lymph Node Excision / Q000009:adverse effects*; D015412:Mastectomy, Segmental / Q000009:adverse effects*; D008875:Middle Aged; D009819:Office Visits; D012189:Retrospective Studies; D049291:Seroma / Q000209:etiology* / Q000628:therapy; D013997:Time Factors