title: Current practice patterns of drain usage amongst UK and Irish surgeons performing bilateral breast reductions: Evidence down the drain.
abstract: BACKGROUND
  Bilateral breast reduction (BBR) is one of the most frequently performed female breast operations. Despite no evidence supporting efficacy of drain usage in BBRs, postoperative insertion is common. Recent high quality evidence demonstrating potential harm from drain use has subsequently challenged this traditional practice. The aim of this study is to assess the current practice patterns of drains usage by Plastic & Reconstructive and Breast Surgeons in UK and Ireland performing BBRs.
  
  
  METHODS
  An 18 question survey was created evaluating various aspects of BBR practice. UK and Irish Plastic & Reconstructive and Breast Surgeons were invited to participate by an email containing a link to a web-based survey. Statistical analysis was performed with student t-test and chi-square test.
  
  
  RESULTS
  Two hundred and eleven responding surgeons were analysed, including 80.1% (171/211) Plastic Surgeons and 18.9% (40/211) Breast Surgeons. Of the responding surgeons, 71.6% (151/211) routinely inserted postoperative drains, for a mean of 1.32 days. Drains were used significantly less by surgeons performing ≥20 BBRs (p = 0.02). With the majority of BBRs performed as an inpatient procedure, there was a trend towards less drain usage in surgeons performing this procedure as an outpatient; however, this was not statistically significant (p = 0.07).
  
  
  CONCLUSIONS
  Even with the high level of evidence demonstrating the safety of BBR without drains, they are still routinely utilised. In an era of evidence- based medicine, surgeons performing breast reductions must adopt the results from scientific research into their clinical practice.
authors.affiliation: a 1 Department of Plastic & Reconstructive Surgery.
authors.forename: Conor M
authors.initials: CM
authors.lastname: Sugrue
authors.affiliation: a 1 Department of Plastic & Reconstructive Surgery.
authors.forename: Niall
authors.initials: N
authors.lastname: McInerney
authors.affiliation: a 1 Department of Plastic & Reconstructive Surgery.
authors.forename: Cormac W
authors.initials: CW
authors.lastname: Joyce
authors.affiliation: a 1 Department of Plastic & Reconstructive Surgery.
authors.forename: Deidre
authors.initials: D
authors.lastname: Jones
authors.affiliation: a 1 Department of Plastic & Reconstructive Surgery.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Hussey
authors.affiliation: a 1 Department of Plastic & Reconstructive Surgery.
authors.forename: Jack L
authors.initials: JL
authors.lastname: Kelly
authors.affiliation: b 2 Department of Breast Surgery, Galway University Hospital , Galway, Ireland.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Kerin
authors.affiliation: a 1 Department of Plastic & Reconstructive Surgery.
authors.forename: Padraic J
authors.initials: PJ
authors.lastname: Regan
mesh_terms: D000328:Adult; D001940:Breast / Q000601:surgery*; D004322:Drainage / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006801:Humans; D007494:Ireland; D016462:Mammaplasty / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D061214:Patient Safety; D011182:Postoperative Care / Q000379:methods; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011300:Preoperative Care / Q000379:methods; D066231:Surgeons / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D006113:United Kingdom
keywords: Breast reduction; plastic surgery