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Seroma rates with one vs. two drains in direct-to-implant reconstruction

Claire Oliver, Ashley Leberfinger, Derek Cody
Summa
2023-02-10

Presenter: Claire Oliver

Affidavit:
Ananth Murthy

Director Name: Ananth Murthy

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)

Background: Seroma is a common complication following implant-based breast reconstruction and is associated with negative outcomes. Intraoperative drain placement is one strategy to mitigate seroma formation. Currently there is no consensus whether one drain or two is optimal to reduce seroma development. We hypothesize that using a single drain does not increase the risk of seroma compared to two drains in direct-to-implant reconstruction.

Methods: This is a retrospective cohort study of patients who underwent direct-to-implant breast reconstruction with acellular dermal matrix at a single institution over a two-year period. Patients underwent reconstruction with placement of one or two drains. Charts were reviewed for post-operative rates of seroma development. Secondary variables including infection, secondary procedures for seroma evacuation, and implant loss associated with infected fluid collection were also investigated.

Results: A total of 186 breasts in 119 patients who underwent direct-to-implant breast reconstruction were evaluated. Of these, 141 breasts received reconstructions with two drains and 45 with a single drain. Preliminary data does not demonstrate an increased risk of seroma development with the use of a single drain compared to two drains.

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