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Drainless mastectomy: Is it safe and effective?

Elizabeth Baker¹, Jennifer Piper¹

¹York Teaching Hospitals NHS Foundation Trust, United Kingdom.

The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

|February 25, 2016

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Omitting post-operative drains after simple mastectomy may increase seroma formation and fluid volume. Drainless mastectomy is safe but may necessitate increased post-operative interventions for seroma management.

Area of Science:

Oncology
Surgical Oncology
Breast Surgery

Background:

Post-operative drain use after simple mastectomy exhibits wide practice variation.
The necessity of drains to prevent complications like seroma formation is debated.

Purpose of the Study:

To investigate whether omitting drains after simple mastectomy increases post-operative seroma formation or other complications.
To compare outcomes between patients with and without post-operative drains following simple mastectomy.

Main Methods:

A retrospective study included women undergoing simple mastectomy ± sentinel node biopsy.
Patients were assigned to drain or no-drain groups by the operating surgeon.
Data collected included drain output, length of stay, seroma formation and volume, and complications.

Keywords:

Drain Mastectomy Seroma

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Main Results:

The no-drain group had a higher prevalence of seroma (83% vs. 62%) requiring more aspirations and larger drained volumes (725 ml vs. 360 ml).
No significant differences were observed in patient demographics (age, BMI, specimen weight) or overall complication rates.
Seroma formation did not correlate with age, BMI, or mastectomy weight.

Conclusions:

Post-operative drains following simple mastectomy may reduce seroma formation rates and total fluid volume.
Drainless mastectomy is a potentially safe approach but may require increased post-operative interventions for seroma management.