A prospective randomized trial of high versus low vacuum drainage after axillary dissection for breast cancer

• Published in: The American journal of surgery 1997-02, Vol.173 (2), p.76-79
• Main Authors: Bonnema, Jorien, van Geel, Albert N., Ligtenstein, David A., Schmitz, Paul I.M., Wiggers, Theo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Axilla - surgery; Biological and medical sciences; Body mass; Body Mass Index; Body size; Breast cancer; Breast Neoplasms - surgery; Complications; Dissection; Drainage - adverse effects; Drainage - methods; Drainage systems; Equipment Failure; Female; Gynecology. Andrology. Obstetrics; High vacuum; Humans; Incidence; Low vacuum; Lumpectomy; Lymph Node Excision; Lymphatic Metastasis; Mammary gland diseases; Mastectomy, Modified Radical; Mastectomy, Segmental; Medical sciences; Middle Aged; Postoperative Care - methods; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Prospective Studies; Statistical analysis; Statistics, Nonparametric; Tumors; Vacuum; Wound drainage
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/S0002-9610(96)00416-3

The influence of negative pressure on fluid production and complication rates after axillary dissection for breast cancer was studied in a prospective randomized trial. Patients were randomized for either a high or a low vacuum drainage system. Drainage volumes and complication rates were recorded. No statistically significant differences were found between the low vacuum group (n = 68) and the high vacuum group (n = 73) in volume (728 ml versus 780 ml) and duration (9.5 days versus 10 days) of seroma production, number of wound complications (5 versus 6), or infections (3 versus 2). There was a significant positive relationship between body mass index and seroma production, independent of the drainage system ( P = 0.002). The drainage volume of the separately drained breast wound after mastectomy and lumpectomy was larger for the high vacuum system (55 ml versus 100 ml, P = 0.02). Vacuum loss was more frequent in the high vacuum drain group (11 versus 2, P = 0.01), where as leakage around the drain occurred more often in the low vacuum group (18 versus 6, P = 0.004). There are no differences in axillary fluid production or wound complication rates after axillary dissection and subsequent drainage between high and low vacuum drainage systems.