Comparative Study between Jackson-Pratt Drain and Redivac Drain in Prevention of Seroma Formation after Oncoplastic Breast Surgery | ||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||
| Article 10, Volume 47, Issue 3, July 2023, Pages 231-237 PDF (758.11 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejprs.2023.309734 | ||
| Authors | ||
| Ahmed Alaa Shaat* 1; Nasser A Ghozlan2; Yasser S Hamed1; Ayman F Mohamed3; Moustafa R Abou El Seoud3; Ahmed Zidan3 | ||
| 1The Department of Surgery, Medical Research Institute, Alexandria University | ||
| 2Department of Plastic Surgery, Faculty of Medicine; Alexandria University | ||
| 3The Department of Surgery*, Medical Research Institute, Alexandria University; Alexandria University | ||
| Abstract | ||
| Background: Seroma formation is frequently observed in oncoplastic breast surgeries, seroma development is a common postoperative complication that causes significant patient morbidity. Objective: This study aimed to compare between the effect of using Jackson-Pratt drain and Redivac drain in patients undergoing oncoplastic surgeries in seroma formation. Patients and Methods: Eighty female patients with confirmed diagnosed cancer breast Underwent different oncoplastic breast surgery between November 2021 and December 2022 in Medical Research Institute, Alexandria University. All patients subjected to the same preoperative preparations. Patients were randomized to both group A and group B by double blinded randomized controlled method. Group A: (using Jackson-Pratt drain) and Group B: (using conventional Redivac drain). Seroma was detected by clinical examination at 2, 4, 6, and 8 weeks postoperative. Results: The mean BMI was 23.0-40.2 (31.0) in group A Vs. 26.0-35.1 (30.0) in group B. The mean time until drains removal was 7-16 (11.5) days in group A Vs. 4-18 (10.8) days in group B. Total drain discharge was in the Jackson drain group (685.33ml) Vs. (915.27ml) in the redivac drain group. Five cases of 40 cases came with seroma in group A with range of amount (190-440) ml and mean amount (278) ml while fifteen cases in group B with range of amount (100- 810) and mean amount (482.5) ml in group B. The Number of cases complicated with delayed seroma was 1 case (2.5%) in group A (n=40) while 4 cases (10%) in group B (n=40). Pain score was in group A ranged from 1-4 with mean value 3.2±0.7 and in group B ranged from 2-5 with mean value 4.0±1.0. Conclusion: Using Jackson-pratt drain is reliable and efficient in reducing seroma formation in different breast surgery techniques especially reconstructive breast surgeries and is very successful to minimize pain associated the drain in comparison to conventional redivac drain. | ||
| Keywords | ||
| Breast cancer; Oncoplastic; Seroma | ||
| References | ||
|
Gonzalez E.A., Saltzstein E.C., Riedner C.S. and Nelson B.K.: Seroma formation following breast cancer surgery. Breast J., 9 (5): 385-8, 2003. 2- Hashemi E., Kaviani A., Najafi M., Ebrahimi M., Hooshmand H. and Montazeri A.: Seroma formation after surgery for breast cancer. World J. Surg. Oncol., 2: 44, 2004. 3- Kuroi K., Shimozuma K., Taguchi T., Imai H., Yamashiro H., Ohsumi S., et al.: Effect of mechanical closure of dead space on seroma formation after breast surgery. Breast Cancer, 13 (3): 260-5, 2006. 4- Nespoli L., Antolini L., Stucchi C., Nespoli A., Valsecchi M.G. and Gianotti L.: Axillary lymphadenectomy for breast cancer. A randomized controlled trial comparing a bipolar vessel sealing system to the conventional technique. Breast, 21 (6): 739-45, 2012. 5- van Bemmel A.J., van de Velde C.J., Schmitz R.F. and Liefers G.J.: Prevention of seroma formation after axillary dissection in breast cancer: A systematic review. Eur. J. Surg. Oncol., 37 (10): 829-35, 2011. 6- Papanikolaou A., Minger E., Pais M.A., Constantinescu M., Olariu R., Grobbelaar A., et al.: Management of Postoperative Seroma: Recommendations Based on a 12- Year Retrospective Study. J. Clin. Med., 11 (17), 2022. 7- Bailey S.H., Oni G., Guevara R., Wong C. and Saint-Cyr M.: Latissimus dorsi donor-site morbidity: The combination of quilting and fibrin sealant reduce length of drain placement and seroma rate. Ann. Plast. Surg., 68 (6): 555- 8, 2012. 8- Almond L.M., Khodaverdi L., Kumar B. and Coveney E.C.: Flap Anchoring Following Primary Breast Cancer Surgery Facilitates Early Hospital Discharge and Reduces Costs. Breast Care (Basel), 5 (2): 97-101, 2010. 9- Gambardella C., Clarizia G., Patrone R., Offi C., Mauriello C., Romano R., et al.: Advanced hemostasis in axillary lymph node dissection for locally advanced breast cancer: New technology devices compared in the prevention of seroma formation. BMC Surgery, 18 (1): 125, 2019. 10- Ghossain A. and Ghossain M.A.: History of mastectomy before and after Halsted. J. Med. Liban, 57 (2): 65-71, 2009. 11- Khan S.M., Smeulders M.J. and Van der Horst C.M.: Wound drainage after plastic and reconstructive surgery Egypt, J. Plast. Reconstr. Surg., July 2023 237 of the breast. Cochrane Database Syst. Rev., 2015 (10): Cd007258, 2015. 12- Chen C.F., Lin S.F., Hung C.F. and Chou P.: Risk of infection is associated more with drain duration than daily drainage volume in prosthesis-based breast reconstruction: A cohort study. Medicine (Baltimore), 95 (49): e5605, 2016. 13- Degnim A.C., Hoskin T.L., Brahmbhatt R.D., Warren- Peled A., Loprinzi M., Pavey E.S., et al.: Randomized trial of drain antisepsis after mastectomy and immediate prosthetic breast reconstruction. Ann. Surg. Oncol., 21 (10): 3240-8, 2014. 14- Benedetti-Panici P., Maneschi F., Cutillo G., D'Andrea G., di Palumbo V.S., Conte M., et al.: A randomized study comparing retroperitoneal drainage with no drainage after lymphadenectomy in gynecologic malignancies. Gynecol. Oncol., 65 (3): 478-82, 1997. 15- McCarthy C.M., Disa J.J., Pusic A.L., Mehrara B.J. and Cordeiro P.G.: The effect of closed-suction drains on the incidence of local wound complications following tissue expander/implant reconstruction: A cohort study. Plast. Reconstr. Surg., 119 (7): 2018-22, 2007. 16- Iwuagwu O.C., Platt A.J. and Drew P.J.: Breast reduction surgery in the UK and Ireland - current trends. Ann. R Coll. Surg. Engl., 88 (6): 585-8, 2006. 17- Salihi S. and Kızıltan H.T.: Does using Jackson-Pratt drain affect the incidence of sternal wound complications after open cardiac surgery? Turk Gogus Kalp Damar Cerrahisi Derg., 27 (1): 15-22, 2019. 18- Jackson F.E. and Pratt R.A., 3rd: Technical report: A silicone rubber suction drain for drainage of subdural hematomas. Surgery, 70 (4): 578-9, 1971. 19- Jackson F.E. and Pratt R.A.: Silicone rubber "brain drain". Z Neurol., 201 (1): 92-4, 1972. 20- Ebner F.K., Friedl T.W., Degregorio N., Reich A., Janni W. and Rempen A.: Does Non-Placement of a Drain in Breast Surgery Increase the Rate of Complications and Revisions? Geburtshilfe Frauenheilkd, 73 (11): 1128-34, 2013. 21- Tadych K. and Donegan W.L.: Postmastectomy seromas and wound drainage. Surg. Gynecol. Obstet., 165 (6): 483-7, 1987. 22- Memon F., Ahmed A., Parveen S., Iqbal S., Anwar A. and Hashmi A.A.: Outcomes of Harmonic Scalpel and Electrocautery in Patients Who Underwent Modified Radical Mastectomy. Cureus, 12 (12): e12311, 2020. 23- Chang Y.W., Kim H.S., Jung S.P., Woo S.U., Lee J.B., Bae J.W., et al.: Comparison of skin-sparing mastectomy using LigaSure™ Small Jaw and electrocautery. World J. Surg. Oncol., 15 (1): 129, 2017. 24- Prakash J.S., Luther A. and Deodhar M.: Modified radical mastectomy and wound drainage, 2015. 25- Jackson P.C., MacInnes E.G., Nicholson J.K., Brayshaw I., Relton S. and Achuthan R.: Mastectomy Without Drains Reduces Cost with No Detriment to Patient Outcome. Cureus, 11 (7): e5160, 2019. 26. Chintamani, Singhal V., Singh J., Bansal A. and Saxena S.: Half versus full vacuum suction drainage after modified radical mastectomy for breast cancer-a prospective randomized clinical trial [ISRCTN24484328]. BMC Cancer, 5: 11, 2005. 27- Bonnema J., van Geel A.N., Ligtenstein D.A., Schmitz P.I. and Wiggers T.: A prospective randomized trial of high versus low vacuum drainage after axillary dissection for breast cancer. Am. J. Surg., 173 (2): 76-9, 1997. 28- van Heurn L.W. and Brink P.R.: Prospective randomized trial of high versus low vacuum drainage after axillary lymphadenectomy. Br. J. Surg., 82 (7): 931-2, 1995. 29- Faisal M., Fathy H., Shaban H., Abuelela S.T., Marie A. and Khaled I.: A novel technique of harmonic tissue dissection reduces seroma formation after modified radical mastectomy compared to conventional electrocautery: A single-blind randomized controlled trial. Patient Saf Surg., 12: 8, 2018. 30- Khaled I., Saad I., Soliman H. and Faisal M.: Ultrasonic Shear Device versus Monopolar Electric Cautery in Conservative Breast Surgery Following Neoadjuvant Chemotherapy: A Comparative Study. Research Square, 1-19, 2021 | ||
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