A little article about drains and seromas

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Drains and Seromas in TRAM Flap Breast Reconstruction.

Original Articles

ls of Plastic Surgery. 48(5):511-514, May 2002.

Scevola, Silvia MD; Youssef, Adel MD, PhD; Kroll, S. MD +; Langstein, MD

Abstract:

Surgeons who perform transverse rectus abdominis musculocutaneous(TRAM) flaps have differing opinions about how many drains are required in the breast and abdomen to prevent seroma. The authors therefore decided to review their experience to determine whether the number ofdrains influenced the incidence of seroma. All patients who underwentbreast reconstruction using TRAM or deep inferior epigastric perforatorflaps at The University of Texas M. D. Cancer Center fromJanuary 1, 1995 to June 20, 2000 and whose charts could be retrievedwere included in the study. The number of drains used was correlatedwith the presence or absence of seroma and wound infection in both theabdomen and the breast. Significance was analyzed using the Chi-squaredand Fisher's exact tests. There were 608 patients and 768reconstructive procedures in this series (160 reconstructions werebilateral). Of patients who had only one drain in the abdomen, seromadeveloped in 9 patients (7.1%), whereas of those having two drains inthe abdomen, seroma developed in only 10 patients (2.1%) (p = 0.006).Also, of patients who had only one drain in the breast, seromadeveloped in the breast in 47 patients (9.1%), and in those with twodrains, seroma developed in only 11 patients (4.3%) (p = 0.02). Therewere no significant differences in the infection rate in either thebreast or the abdomen, although the trends favored a lower infectionrisk when two drains were used. The authors found that using two drainsin both the abdomen and the breast can reduce the risk for seromawithout increasing the risk for infection. This study supports the useof two drains in both the breast (one each beneath the TRAM flap and inthe axilla) and abdomen (beneath the abdominoplasty flap) for patientsundergoing breast reconstruction using the TRAM flap.

© 2002 Lippincott & Wilkins, Inc.

http://www.annalsplasticsurgery.com/pt/re/annps/abstract.00000637-200205000-00011.htm;jsessionid=LmRfhyJk9NHypWfDj8vsnp73SY55yxx7bLJGCyzcVtlrN6Lm6pQQ!2129441969!181195629!8091!-1

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