HOW LONG SHOULD SUCTION DRAINS STAY IN AFTER BREAST SURGERY WITH AXILLARY DISSECTION

Daily suction drainage volumes were recorded for 63 patients after wid e local excision of a breast carcinoma with axillary dissection (n=37) or mastectomy with axillary dissection (n=26). Suction drains were re moved at the discretion of the clinical ward staff after a median of 4 days (range 1-7 days). In all, 32 patients (51%) later developed sero mas requiring needle aspiration. Minor wound infection rate was not si gnificantly higher in patients who developed seromas than those who di d not (5 vs 2). Seroma formation was associated with a larger total su ction drain volume (mean 480 mi (range 28-1150 mi) vs 240 ml (range 10 -635 ml); P=0.0001). The median yield of axillary lymph nodes was sign ificantly greater in those who developed seromas (11 (range 4-20) vs 8 (range 1-19); P= 0.002). There was no difference in the volume draine d in the 24 h preceding drain removal (mean 60 mi (range 0-150 mi) vs 50 mi (range 0-290 mi); NS). Keeping drains in situ longer did not pro tect against seroma formation. By 48 h, 74% of the total volume draine d by each drain had been collected. Seroma formation after breast surg ery with axillary dissection is an inconvenience for a high proportion of patients. This complication does not seem to be reduced by prolong ed suction drainage of the wound, which in itself delays patient disch arge and causes further inconvenience.