Kopelman D, Klemm O, Bahous H, Klein R, Krausz M, Hashmonai M
Department of Surgery B, Rambam Medical Centre, Carmel Hospital, Haifa, Israel.
Eur J Surg. 1999 Feb;165(2):117-20; discussion 121-2. doi: 10.1080/110241599750007289.
To define the correct time to remove the drain after axillary dissection for carcinoma of the breast.
Prospective randomised trial.
Two public hospitals, Israel.
90 women who required axillary dissection for carcinoma of the breast.
42 were randomised to have the drain removed on postoperative day 3, and 48 to keep the drain in until discharge had decreased to less than 35 ml/24 hours.
Formation of seromas or wound infections, need to reinsert the drain, and duration of hospital stay.
Early removal of the axillary drain was associated with a significantly higher incidence of seromas (9/42 compared with 2/48, p = 0.02) unless the total amount of fluid drained during the first three postoperative days was less than 250 ml.
Drains should be removed after axillary dissection only when the daily amount of fluid discharged is low, unless the drainage during the first three days is less than 250 ml.
确定乳腺癌腋窝清扫术后引流管的正确拔除时间。
前瞻性随机试验。
以色列的两家公立医院。
90名因乳腺癌需要进行腋窝清扫的女性。
42名患者被随机分配在术后第3天拔除引流管，48名患者则保留引流管直至引流量降至24小时内少于35毫升。
血清肿或伤口感染的形成、引流管重新插入的必要性以及住院时间。
除非术后前三天的总引流量少于250毫升，否则早期拔除腋窝引流管会使血清肿的发生率显著更高（9/42对比2/48，p = 0.02）。
仅当每日引流量较低时，腋窝清扫术后才应拔除引流管，除非术后前三天的引流量少于250毫升。
