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Updated: Jan 6, 2026
Single-Port Robotic-assisted Transaxillary Breast-conserving Surgery: A Prospective, Single-arm, Non-randomized Phase IIa Clinical Trial
Published on: August 19, 2025
"Safety and efficacy of early drain removal in breast reconstruction: a retrospective cohort study"
Daiju Goto1, Azusa Oshima2, Tatsuya Onishi3
1Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, Japan. daiju1023goto@gmail.com.
Background:
Closed-suction drains are routinely used in breast reconstruction, but evidence regarding early removal remains limited. This study evaluated whether early drain removal affects local wound complications.
Methods:
We retrospectively reviewed patients who underwent breast reconstruction with tissue expanders (TE), implants, or autologous tissue between January 2019 and August 2024. Patients were divided into two groups: a volume-based group (drains removed when output < 30 mL/24 h) and an early-removal group (drains removed within 4 days postoperatively). Incidences of seroma, surgical site infection (SSI), and implant removal within one year postoperatively were compared.
Results:
A total of 265 reconstructions in 241 patients were analyzed (134 volume-based, 131 early-removal). Seroma incidence was similar between groups. However, SSI occurred significantly less frequently in the early-removal group than in the volume-based group (21/134 (15.7%) vs. 9/131 (6.9%), p = 0.032). This reduction was evident only in TE/implant-based reconstructions. Multivariable analysis identified early drain removal as an independent protective factor against SSI (OR, 0.316; p = 0.015).
Conclusions:
Early drain removal within 4 days does not increase seroma risk and is associated with a significantly lower SSI rate in TE/implant-based breast reconstruction. These findings suggest early drain removal is both safe and beneficial in selected patients.
