Early removal of drains and the incidence of seroma after breast surgery

Women undergoing surgery for primary breast cancer routinely have suction drains inserted deep to the wounds. A lack of data exists in relating how long suction drains should stay in situ after major breast surgery. This study evaluates the appropriate timing of drain removal by comparing the 5-day-long postoperative drainage or drain removal when less than 50 mL/24 h to conventional drain removal. This controlled clinical trial was undertaken between February 1997 and May 2012 with a total of 214 consecutive patients who underwent elective total or partial mastectomy with level II axillary lymph node dissection. The main outcome measures included the length of hospital stay, and surgical morbidity, especially seroma formation. In the study group, the age and operation time were significantly increased compared to the conventional group whereas the median hospital stay was significantly shorter in the study group than the control group (7 days vs. 9 days; p < 0.05). The incidence of seroma was 42.8 % in the study group and 31.6 % in the control group (p = 0.14). The mean number of outpatient visits for seroma was 3.6 in the study group and 1.5 in the control group (p < 0.05). Drainage volume of more than 150 mL/24 h all resulted in seroma formation. The new criteria for early drain removal are safe and acceptable despite the slightly increased chance of seroma formation.