BACKGROUND:Women undergoing surgery for primary breast cancer routinely have suction drains inserted deep to the wounds, which are removed approximately 6-8 days after operation, requiring a period of stay of that duration in hospital. The aim of this study was to perform a prospective randomized clinical trial to evaluate a new surgical technique of suturing flaps without wound drainage, combined with early discharge, in women undergoing surgery for breast cancer. METHODS: A total of 375 patients undergoing surgery for breast cancer were randomized to conventional surgery or suturing of flaps with no drain. The main outcome measures were length of hospital stay, surgical morbidity, psychological morbidity and health economics. RESULTS:Suturing of flaps and avoiding wound drainage in women undergoing surgery for breast cancer resulted in a significantly shorter hospital stay. Adopting this surgical technique with early discharge did not lead to any difference in surgical or psychological morbidity. Health economic benefits to the National Health Service resulted from saved bed days with no impact on community costs. CONCLUSION: Wound drainage following surgery for breast cancer can be avoided, thereby facilitating early discharge with no associated increase in surgical or psychological morbidity.
RCT Entities:
BACKGROUND:Women undergoing surgery for primary breast cancer routinely have suction drains inserted deep to the wounds, which are removed approximately 6-8 days after operation, requiring a period of stay of that duration in hospital. The aim of this study was to perform a prospective randomized clinical trial to evaluate a new surgical technique of suturing flaps without wound drainage, combined with early discharge, in women undergoing surgery for breast cancer. METHODS: A total of 375 patients undergoing surgery for breast cancer were randomized to conventional surgery or suturing of flaps with no drain. The main outcome measures were length of hospital stay, surgical morbidity, psychological morbidity and health economics. RESULTS: Suturing of flaps and avoiding wound drainage in women undergoing surgery for breast cancer resulted in a significantly shorter hospital stay. Adopting this surgical technique with early discharge did not lead to any difference in surgical or psychological morbidity. Health economic benefits to the National Health Service resulted from saved bed days with no impact on community costs. CONCLUSION: Wound drainage following surgery for breast cancer can be avoided, thereby facilitating early discharge with no associated increase in surgical or psychological morbidity.
Authors: Mascha de Kok; Trudy van der Weijden; Alfons Kessels; Carmen Dirksen; Cornelis van de Velde; Jan Roukema; Fred van der Ent; Antoine Bell; Maarten von Meyenfeldt Journal: World J Surg Date: 2008-12 Impact factor: 3.352
Authors: Ruvinder Athwal; Mahmood Dakka; Donna Appleton; Simon Harries; Dayalan Clarke; Lucie Jones Journal: Breast Care (Basel) Date: 2015-02 Impact factor: 2.860
Authors: Florian Ebner; Niko deGregorio; Elena Vorwerk; Wolfgang Janni; Achim Wöckel; Dominic Varga Journal: Breast Care (Basel) Date: 2014-05 Impact factor: 2.860