The effect of closed-suction drains on the incidence of local wound complications following tissue expander/implant reconstruction: a cohort study.

BACKGROUND

The purpose of this investigation was to evaluate the effect of drains on complications, including infection, seroma, and hematoma formation, in patients undergoing exchange of a temporary expander for a permanent breast implant.

METHODS

A review of all tissue expander/implant breast reconstructions performed at a single center from 1997 to 2004 was undertaken. Two patient cohorts were identified: patients who underwent exchange of their expander to a permanent implant with the use of closed-suction drains and patients who underwent the exchange procedure without the use of drains. The incidence of infection, seroma, and hematoma formation was determined for each cohort. Chi-square and two-sample t tests were performed for categorical and continuous variables, respectively.

RESULTS

A total of 2446 exchange procedures in 1863 patients were performed. In 1495 reconstructions (1165 patients), drains were placed after the exchange procedure; in 951 reconstructions (698 patients), no drains were used. There was no difference in the overall rate of complications following the exchange procedure with or without the use of drains (p = 0.886). Specifically, there was no difference in the incidence of infection necessitating implant removal in the presence of drains compared with that in the absence of drains (p = 0.585). Similarly, there was no significant difference in the rate of hematoma/seroma formation with or without the use of drains (p = 0.742).

CONCLUSION

The use of periprosthetic, closed-suction drains after exchange of a temporary expander for a permanent breast implant does not affect the incidence of perioperative complications, including infection, seroma, and hematoma formation.