No-drain Technique in Abdominal Closure for Breast Reconstruction: Lower Complication Rate, Shorter Hospitalization Stay
| Autor: | Tze Yean Kong, Claire L Rutherford, Stephanie L S Chan |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Abdominoplasty Demographics business.industry medicine.medical_treatment Retrospective cohort study 030230 surgery medicine.disease Surgery 03 medical and health sciences 0302 clinical medicine Suture (anatomy) 030220 oncology & carcinogenesis Seroma medicine Complication rate Original Article Complication Breast reconstruction business |
| Zdroj: | Plastic and Reconstructive Surgery Global Open |
| ISSN: | 2169-7574 |
| Popis: | Background Progressive tension suture (PTS) technique in cosmetic abdominoplasty is safe in terms of seroma rates. This was extrapolated to deep inferior epigastric perforator (DIEP) flap donor site closure. No study to our knowledge has analyzed the PTS technique alone without drains in transverse rectus abdominis musculocutaneous (TRAM) flap donor sites. We aim to show that no-drain closure has similar complication rates and this may be applied to TRAM flaps safely even though they have higher drain output. Methods A single-center, single-surgeon retrospective study was performed over 4 years. Patients undergoing breast reconstruction with an abdominal flap were included. Data collected included patient's demographics, type of flap, usage of drains or PTS technique, drain output, date of fitness for discharge, date of discharge, and seroma rates. The outcomes studied were drain volumes, seroma rates, and duration of hospital stay. Results Fifty patients were recruited. The first 25 patients (13 DIEP and 12 TRAM) underwent conventional closure. The subsequent 25 patients (17 DIEP and 8 TRAM) underwent PTS technique. TRAM flaps had higher drain volume (785.6 mL) compared to DIEP flaps (366.2 mL) (P = 0.047). No patients developed a seroma. Patients who underwent the PTS technique had lower abdominal-specific complications (P = 0.021). Patients without drains were discharged faster at 5.4 versus 8.2 days (P ≤ 0.001). Conclusions Patients who underwent the PTS technique had lower complication rates, faster time to fitness for discharge and shorter hospitalization stay. The PTS technique may be applied to TRAM flaps safely. |
| Databáze: | OpenAIRE |
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