Luiz Charles-de-Sá1, Natale Ferreira Gontijo-de-Amorim2, Julia Klein Rossi3, Alexandre Malta da Costa Messeder4, Luciana Nogueira de Araujo Jorge5, Denise Salles Coelho da Mota6, José Horácio Aboudib7. 1. Department of Plastic, Reconstructive and Aesthetic Surgery, Training and Research State University Hospital of Rio de Janeiro - UERJ-RJ, av. Mal.Rondon, 381.São francisco Xavier. Rio de Janeiro. CEP: 20950-003, Brazil; Perfoma Clinic - Natal, Brazil; Pitanguy Institute, Rio de Janeiro, Brazil. Electronic address: clinicaperforma@uol.com.br. 2. Pitanguy Institute, Rio de Janeiro, Brazil; Perfoma Clinic - Rio de Janeiro, Brazil. Electronic address: natalefga@yahoo.com.br. 3. Department of Plastic Surgery of the Pitanguy Institute - Rio de Janeiro, Brazil. Electronic address: juliaklein@hotmail.com. 4. Radiology Department of State University of Rio de Janeiro, UERJ-RJ, Brazil. Electronic address: messederalexandre@gmail.com. 5. Radiology Department of State University of Rio de Janeiro, UERJ-RJ, Brazil. Electronic address: lunogueira.aj@hotmail.com. 6. Department of Plastic, Reconstructive and Aesthetic Surgery, Training and Research State University Hospital of Rio de Janeiro - UERJ-RJ, av. Mal.Rondon, 381.São francisco Xavier. Rio de Janeiro. CEP: 20950-003, Brazil. Electronic address: denisedamota@hotmail.com. 7. Department of Plastic, Reconstructive and Aesthetic Surgery, Training and Research State University Hospital of Rio de Janeiro - UERJ-RJ, av. Mal.Rondon, 381.São francisco Xavier. Rio de Janeiro. CEP: 20950-003, Brazil. Electronic address: jhaboudib@gmail.com.
Abstract
BACKGROUND: Breast prostheses could be associated with complications, despite many studies on surgical materials and techniques. The role of surgical drainage in preventing complications on breast prostheses surgery is controversial. OBJECTIVES: This study aimed to evaluate the role and effectiveness of vacuum drainage in the augmentation mammoplasty. METHODS: A prospective multicentric randomized comparative clinical trial was conducted with 150 patients, who were the candidates for breast augmentation. The candidates were split into two groups to analyze the breast drain role. Group1: closed-suction drainage; measurements were taken every 24 h for 48 h. Group2: control (no drainage); all the patients were submitted to a clinical and postoperative ultrasonography evaluation (7th day and 3rd month). The late consultations (1st-, 2nd-, and 3rd-year postoperative time) were carried out to identify any complication, such as infection, seroma, hematoma, asymmetry, hypertrophic scarring, rippling, implant position, visible edges, and sensibility alteration. RESULTS: A total of 150 female patients were operated with 300 breast implants placed into subglandular pocket. In the first 24 h postoperative (D1), the drainage volume ranged from 12 ml to 210 ml (mean= 74.90 ml; SD= 43.29 ml). After 24 h, on the second day (D2), the collected volume ranged from 10 ml to 120 ml (mean= 44.76 ml; SD= 24.80 ml). The total drainage volume in the 48 h ranged from 22 ml to 320 ml (mean= 119.7 ml; SD= 62.20 ml). The breast ultrasonography series (BUSGS) analysis was done on the 7th day and 3rd month in both groups. There was no significant difference between G1 and G2 groups (p = 0.05 and 0.25, respectively). In the follow-up, some patients (33-44%) declared sensitivity disturbing on the nipple-areola complex (NAC) and lower breast segment. CONCLUSIONS: The closed-suction breast drainage in breast augmentation was associated with high cost and time-consuming and not demonstrated any benefit in a recent postoperative time.
RCT Entities:
BACKGROUND: Breast prostheses could be associated with complications, despite many studies on surgical materials and techniques. The role of surgical drainage in preventing complications on breast prostheses surgery is controversial. OBJECTIVES: This study aimed to evaluate the role and effectiveness of vacuum drainage in the augmentation mammoplasty. METHODS: A prospective multicentric randomized comparative clinical trial was conducted with 150 patients, who were the candidates for breast augmentation. The candidates were split into two groups to analyze the breast drain role. Group1: closed-suction drainage; measurements were taken every 24 h for 48 h. Group2: control (no drainage); all the patients were submitted to a clinical and postoperative ultrasonography evaluation (7th day and 3rd month). The late consultations (1st-, 2nd-, and 3rd-year postoperative time) were carried out to identify any complication, such as infection, seroma, hematoma, asymmetry, hypertrophic scarring, rippling, implant position, visible edges, and sensibility alteration. RESULTS: A total of 150 female patients were operated with 300 breast implants placed into subglandular pocket. In the first 24 h postoperative (D1), the drainage volume ranged from 12 ml to 210 ml (mean= 74.90 ml; SD= 43.29 ml). After 24 h, on the second day (D2), the collected volume ranged from 10 ml to 120 ml (mean= 44.76 ml; SD= 24.80 ml). The total drainage volume in the 48 h ranged from 22 ml to 320 ml (mean= 119.7 ml; SD= 62.20 ml). The breast ultrasonography series (BUSGS) analysis was done on the 7th day and 3rd month in both groups. There was no significant difference between G1 and G2 groups (p = 0.05 and 0.25, respectively). In the follow-up, some patients (33-44%) declared sensitivity disturbing on the nipple-areola complex (NAC) and lower breast segment. CONCLUSIONS: The closed-suction breast drainage in breast augmentation was associated with high cost and time-consuming and not demonstrated any benefit in a recent postoperative time.