Single versus Double Drainage for Immediate Two-Stage Implant-Based Breast Reconstruction: A Propensity Score-Matched...

Area of Science:

• Plastic Surgery
• Surgical Oncology
• Reconstructive Surgery

Background:

• Conflicting trends exist regarding the number of drains used in implant-based breast reconstruction (IBBR).
• This study addresses the debate on one versus two drains for immediate IBBR using tissue expanders (TE).

Purpose of the Study:

• To compare postoperative outcomes and complications of immediate IBBR with TE using two drains versus a single drain.
• To provide evidence-based guidance for drain selection in IBBR.

Main Methods:

• A propensity score-matched analysis (1:1 nearest neighbor) of 192 patients undergoing immediate two-stage IBBR with TEs.
• Covariables included BMI, mastectomy weight, lymph node surgery, TE surface area, reconstruction plane, acellular dermal matrix use, fluorescence imaging, and intraoperative TE volume.

Main Results:

• No significant differences in 30-day or overall complication rates between one-drain and two-drain groups.
• Comparable times for drain removal, expansion initiation/completion, and TE-to-implant exchange.
• Diabetes and increased estimated blood loss were predictors of seroma formation.

Conclusions:

• One versus two drains yield comparable complication rates and surgical outcomes in immediate IBBR.
• Drain selection should be individualized based on intraoperative findings and patient-specific factors.