Does the Usage of Drains Create a Risk of Surgical Site Infection During Breast Surgery?
Öz
Aim: Drains are used to avoid hematoma, seroma and infection in breast surgery. A topic of debate in breast surgery research is the probability of surgical sites becoming infected through retrograde contamination. In this study, we aimed to determine whether drains cause surgical site infections by using drain tip cultures.
Material and Methods: This study included 162 breasts of 99 patients who had undergone breast surgeries, including augmentation, reduction, reconstruction and gynecomastia, with the same surgeon. Data on the patients’ demographic characteristics, clinical findings, antibiotherapies, types of surgeries and drain features, such as type, duration of use, output volume and tip cultures, were collected retrospectively.
Results: The study included 99 patients—3 male, 96 female—with a mean age of 37.84. The mean body mass index was 24.5. Seven breast augmentations, three gynecomastia surgeries, 37 breast reconstructions with implants, three breast reconstructions with latissimus dorsi flaps and 49 reduction mammoplasties were performed. We did not observe infectious symptoms, such as fever, hyperemia, abscess or hematoma, in any of the patients. Fifty-six Jackson–Pratt® drains and 106 Hemovac drain tip cultures were evaluated. The mean follow-up duration was 7.16 days, and the mean output volume was 224.66 cc. The drain tip cultures of all the patients were negative.
Conclusions: According to our analysis, drains did not cause retrograde contamination or surgical site infection.
Anahtar Kelimeler
Kaynakça
- Harish R, Kazi FN, Sharma JVP. Efficacy of Subcutaneous Closed Suction Drain in Reduction of Postoperative Surgical Site Infection. Surg J (N Y). 2021;7(4):e275-e280. Murray JD, Elwood, Jones GE, Barrick R, Feng J. Decreasing expander breast infection: A new drain care protocol. Can J Plast Surg 2009;17:17-21.
- Scomacao I, Cummins A, Roan E, Duraes EFR, Djohan R. The use of surgical site drains in breast reconstruction: A systematic review. J Plast Reconstr Aesthet Surg. 2020;73:651-662.
- Kim C, Park JW, Song MG, Choi HS. Suction Drain Tip Cultures in Predicting a Surgical Site Infection. Asian Spine J. 2023;17(3):470-476.
- Pennington Z, Lubelski D, Molina C, Westbroek EM, Ahmed AK, Sciubba DM. Prolonged Post-surgical Drain Retention Increases Risk for Deep Wound Infection After Spine Surgery. World Neurosurg. 2019;130:e846-e853.
- Barbadoro P, Marmorale C, Recanatini C, et al. Drainages Collaborative Working Group. May the drain be a way in for microbes in surgical infections? Am J Infect Control. 2016;44:283-8.
- Isik O, Kaya E, Dundar HZ, Sarkut P. Surgical Site Infection: Re-assessment of the Risk Factors. Chirurgia (Bucur). 2015; 110:457-61.
- Teija-Kaisa A, Eija M, Marja S, Outi L. Risk factors for surgical site infection in breast surgery. J Clin Nurs. 2013; 22:948-57.
- Reiffel AJ, Barie PS, Spector JA. A multi-disciplinary review of the potential association between closed-suction drains and surgical site infection. Surg Infect (Larchmt). 2013 ; 14:244-69.
- Zapata-Copete J, Aguilera-Mosquera S, García-Perdomo HA. Antibiotic prophylaxis in breast reduction surgery: A systematic review and meta-analysis. J Plast Reconstr Aesthet Surg. 2017 ; 70:1689-1695.
- Hardwicke JT, Bechar J, Skillman JM. Are systemic antibiotics indicated in aesthetic breast surgery? A systematic review of the literature. Plast Reconstr Surg. 2013 ;131:1395-1403.