Randomized clinical trial of no wound drains and early discharge in the treatment of women with breast cancer

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  • A D Purushotham
    Department of Surgery, University of Glasgow, Edinburgh, UK
  • E McLatchie
    Department of Surgery, University of Glasgow, Edinburgh, UK
  • D Young
    Department of Health Economics, Greater Glasgow Health Board, Edinburgh, UK
  • W D George
    Department of Surgery, University of Glasgow, Edinburgh, UK
  • S Stallard
    Department of Surgery, University of Glasgow, Edinburgh, UK
  • J Doughty
    Department of Surgery, University of Glasgow, Edinburgh, UK
  • D C Brown
    Department of Surgery, University of Glasgow, Edinburgh, UK
  • C Farish
    Department of Physiotherapy, Western Infirmary, Edinburgh, UK
  • A Walker
    Department of Robertson Centre for Biostatistics, University of Glasgow, Edinburgh, UK
  • K Millar
    Department of Psychological Medicine, Gartnavel Royal Hospital, Glasgow, Edinburgh, UK
  • G Murray
    Department of Community Health Sciences, University of Edinburgh, Edinburgh, UK

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<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>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.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>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.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>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.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Wound drainage following surgery for breast cancer can be avoided, thereby facilitating early discharge with no associated increase in surgical or psychological morbidity.</jats:p> </jats:sec>

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