title: Effect of gentamicin lavage of the axillary surgical bed after lymph node dissection on drainage discharge volume.
abstract: The purpose of this study was to evaluate the effect of axillary lavage with a gentamicin solution before wound closure on drainage volume.
  
  
  METHODS
  A prospective, randomized study was performed. Inclusion criteria were a diagnosis of breast neoplasms and plans to undergo an elective axillary lymph node dissection due to axillary metastasis. The patients were randomized into 2 groups: patients undergoing 2 lavages with 500 ml normal saline (Group 1) and patients first undergoing lavage with 500 ml normal saline followed by a second lavage with a 500 ml of a gentamicin (240 mg) solution (Group 2). Microbiological samples were obtained before any lavage, after each lavage and at the time of drain removal.
  
  
  RESULTS
  40 patients were included. Mean number of days maintaining the drain in place was 7.7 ± 3.2 days in Group 1 and 4.3 ± 1.4 days in Group 2 (p = 0.001). Total drainage volume before removal was 465 ± 250.9 ml in Group 1 and 169 ± 102.2 ml in Group 2 (p = 0.003). After a second lavage with normal saline in Group 1 and after a lavage with gentamicin solution in Group 2, microbiological culture was positive in 10 patients (50%) in Group 1 and 1 case (5%) in Group 2 (p = 0.016). Positive cultures were associated with higher drainage volumes.
  
  
  CONCLUSIONS
  The postoperative drainage volume of the axillary drain is significantly lower in the patients undergoing a lavage of the surgical bed with a gentamicin solution than in the control group undergoing a lavage with normal saline. A significant reduction in the contamination is only obtained after a lavage with gentamicin solution.
  
  
  BACKGROUND
  NCT01700504.
authors.affiliation: Department of Surgery, Breast Unit, General University Hospital Elche, Alicante, Spain. Electronic address: jruiztovar@gmail.com.
authors.forename: Jaime
authors.initials: J
authors.lastname: Ruiz-Tovar
authors.forename: Pilar
authors.initials: P
authors.lastname: Cansado
authors.forename: Montserrat
authors.initials: M
authors.lastname: Perez-Soler
authors.forename: María Amparo
authors.initials: MA
authors.lastname: Gomez
authors.forename: Carolina
authors.initials: C
authors.lastname: Llavero
authors.forename: Purificación
authors.initials: P
authors.lastname: Calero
authors.forename: Lorea
authors.initials: L
authors.lastname: Zubiaga
authors.forename: María
authors.initials: M
authors.lastname: Diez
authors.forename: Antonio
authors.initials: A
authors.lastname: Arroyo
authors.forename: Rafael
authors.initials: R
authors.lastname: Calpena
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001365:Axilla / Q000382:microbiology; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D057785:Catheters / Q000382:microbiology; D004322:Drainage; D005122:Exudates and Transudates / Q000382:microbiology*; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage*; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D007507:Therapeutic Irrigation; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins
keywords: Axillary lymph node dissection; Drainage; Gentamicin; Lavage