Law N W, Johnson C D, Lamont P M, Ellis H
Professorial Surgical Unit, Westminster Hospital, London.
Ann R Coll Surg Engl. 1990 Jan;72(1):11-3.
An initial series of 105 women who underwent excision biopsy of the breast were entered into a controlled randomised trial to determine the effect on postoperative morbidity of drainage of the cavity with a soft rubber Penrose drain. The use of this drain had no effect on the incidence of postoperative wound complications (drain 11 of 40 (28%), no drain 10 of 58 (17%]. A second series of 202 women were entered into a randomised controlled trial to determine the effect of closed suction drainage and suture of the cavity after breast biopsy. The use of this drain significantly reduced the incidence of postoperative wound complications (drain 9 of 93 (10%), no drain 22 of 105 (21%], but although suture of the cavity halved the number of wound complications (suture 11 of 97 (11%), no suture 20 of 101 (20%], this did not reach statistical significance. Wound complications were more frequent with large wounds (28%) than with smaller ones (15%), and with less experienced operators (registrar 21%, senior registrar/consultant 10%). We conclude that a closed suction drain will reduce the incidence of wound haematomas after breast biopsy but that a Penrose drain is ineffective in the prevention of wound complications.
最初的105名接受乳房切除活检的女性被纳入一项对照随机试验，以确定使用软橡胶彭罗斯引流管对腔隙引流术后发病率的影响。使用这种引流管对术后伤口并发症的发生率没有影响（使用引流管组40例中有11例（28%），未使用引流管组58例中有10例（17%））。第二组202名女性被纳入一项随机对照试验，以确定乳房活检后使用封闭式负压引流和腔隙缝合的效果。使用这种引流管显著降低了术后伤口并发症的发生率（使用引流管组93例中有9例（10%），未使用引流管组105例中有22例（21%）），但是尽管腔隙缝合使伤口并发症的数量减半（缝合组97例中有11例（11%），未缝合组101例中有20例（20%）），但这未达到统计学显著性。大伤口（28%）的伤口并发症比小伤口（15%）更常见，经验不足的手术医生操作时并发症更多（住院医生为21%，高级住院医生/顾问为10%）。我们得出结论，封闭式负压引流将降低乳房活检后伤口血肿的发生率，但彭罗斯引流管在预防伤口并发症方面无效。
