McCarthy Colleen M, Disa Joseph J, Pusic Andrea L, Mehrara Babak J, Cordeiro Peter G
New York, N.Y. From the Memorial Sloan-Kettering Cancer Center.
Plast Reconstr Surg. 2007 Jun;119(7):2018-2022. doi: 10.1097/01.prs.0000260586.55628.29.
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.
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.
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).
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.
本研究的目的是评估在接受临时乳房扩张器更换为永久性乳房植入物的患者中，引流管对包括感染、血清肿和血肿形成等并发症的影响。
对1997年至2004年在单一中心进行的所有组织扩张器/植入物乳房重建手术进行回顾。确定了两个患者队列：使用闭式吸引引流管将扩张器更换为永久性植入物的患者，以及未使用引流管进行更换手术的患者。确定每个队列中感染、血清肿和血肿形成的发生率。分别对分类变量和连续变量进行卡方检验和双样本t检验。
共对1863例患者进行了2446次更换手术。在1495例重建手术（1165例患者）中，更换手术后放置了引流管；在951例重建手术（698例患者）中，未使用引流管。使用或不使用引流管的更换手术后总体并发症发生率没有差异（p = 0.886）。具体而言，与未使用引流管相比，使用引流管时因感染需要取出植入物的发生率没有差异（p = 0.585）。同样，使用或不使用引流管时血肿/血清肿形成的发生率也没有显著差异（p = 0.742）。
在将临时乳房扩张器更换为永久性乳房植入物后使用假体周围闭式吸引引流管，不会影响包括感染、血清肿和血肿形成在内的围手术期并发症的发生率。
