A comparison of 5-day and 8-day drainage following mastectomy and axillary clearance

Aims: Mastectomy and axillary clearance are standard operations for the treatment of breast carcinoma. Drainage of the mastectomy site and axilla is often required to allow accumulating blood and inflammatory fluids to escape. However, there is a lack of data relating to how long suction drains should stay in situ after major breast surgery. In our study we have tried to address this deficit by comparing the efficacy of 5-day post-operative drainage with 8-day post-operative drainage. Methods: Patients requiring mastectomy and axillary clearance were randomized to having drains removed on day 5 or day 8 post-operatively, The number of lymphoceles, aspirations and total aspiration volumes in chest and axillary drains were compared. Results: From a total of 121 patients enrolled into the study, 64 patients were randomized to the 5-day group and 57 to the 8-day group. There were significant differences regarding the number of aspirations and total aspiration volumes in chest and axillary drains between the two groups, favouring 8-day drainage. However the number of lymphoceles drained in the 5-day group was significantly higher than the 8-day group. Conclusions: Five-day post-operative drainage is as safe as 8-day post-operative drainage in the management of patients undergoing major breast surgery, but results in an increase in lymphocele aspiration and aspiration volume. (C) 2001 Harcourt Publishers Ltd.