Sugrue Conor M, McInerney Niall, Joyce Cormac W, Jones Deidre, Hussey Alan J, Kelly Jack L, Kerin Michael J, Regan Padraic J
a 1 Department of Plastic & Reconstructive Surgery.
b 2 Department of Breast Surgery, Galway University Hospital , Galway, Ireland.
J Plast Surg Hand Surg. 2015;49(6):363-6. doi: 10.3109/2000656X.2015.1062386. Epub 2015 Sep 23.
Bilateral breast reduction (BBR) is one of the most frequently performed female breast operations. Despite no evidence supporting efficacy of drain usage in BBRs, postoperative insertion is common. Recent high quality evidence demonstrating potential harm from drain use has subsequently challenged this traditional practice. The aim of this study is to assess the current practice patterns of drains usage by Plastic & Reconstructive and Breast Surgeons in UK and Ireland performing BBRs.
An 18 question survey was created evaluating various aspects of BBR practice. UK and Irish Plastic & Reconstructive and Breast Surgeons were invited to participate by an email containing a link to a web-based survey. Statistical analysis was performed with student t-test and chi-square test.
Two hundred and eleven responding surgeons were analysed, including 80.1% (171/211) Plastic Surgeons and 18.9% (40/211) Breast Surgeons. Of the responding surgeons, 71.6% (151/211) routinely inserted postoperative drains, for a mean of 1.32 days. Drains were used significantly less by surgeons performing ≥20 BBRs (p = 0.02). With the majority of BBRs performed as an inpatient procedure, there was a trend towards less drain usage in surgeons performing this procedure as an outpatient; however, this was not statistically significant (p = 0.07).
Even with the high level of evidence demonstrating the safety of BBR without drains, they are still routinely utilised. In an era of evidence- based medicine, surgeons performing breast reductions must adopt the results from scientific research into their clinical practice.
双侧乳房缩小术（BBR）是最常施行的女性乳房手术之一。尽管没有证据支持在双侧乳房缩小术中使用引流管的有效性，但术后放置引流管仍很常见。最近的高质量证据表明使用引流管存在潜在危害，这对这种传统做法提出了挑战。本研究的目的是评估英国和爱尔兰进行双侧乳房缩小术的整形与重建外科医生及乳腺外科医生目前使用引流管的实践模式。
设计了一项包含18个问题的调查问卷，评估双侧乳房缩小术实践的各个方面。通过一封包含基于网络调查问卷链接的电子邮件，邀请英国和爱尔兰的整形与重建外科医生及乳腺外科医生参与。采用学生t检验和卡方检验进行统计分析。
对211名回复的外科医生进行了分析，其中包括80.1%（171/211）的整形外科医生和18.9%（40/211）的乳腺外科医生。在回复的外科医生中，71.6%（151/211）常规术后放置引流管，平均放置1.32天。进行≥20例双侧乳房缩小术的外科医生使用引流管的情况明显较少（p = 0.02）。由于大多数双侧乳房缩小术是作为住院手术进行的，进行该手术为门诊手术的外科医生有减少使用引流管的趋势；然而，这在统计学上并不显著（p = 0.07）。
即使有大量证据表明不使用引流管进行双侧乳房缩小术是安全的，但引流管仍被常规使用。在循证医学时代，进行乳房缩小术的外科医生必须将科学研究结果应用于临床实践。
