Vaccum Sealing Drainage Dressing After Modified Radical Mastectomy of Breast Cancer
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 4
Abstract
Background: Suction drains are routinely used after modified radical mastectomy and are an important factor contributing to increased hospital stay as the patients are often discharged only after their removal. Amongst various factors that influence the amount of post-operative drainage, the vaccum sealing drainage dressing applied to the drain has been reported to be of great significance. While negative suction drainage dressing is expected to drain the collection and increase recurrence of infections, it may also prevent the leaking lymphatics from closing and lead to increased drainage from the wound. Against this background a prospective randomized clinical study was conducted to compare the amount and duration of drainage between vacuum sealing drainage dressing and negative suction drainage dressing in patients following modified radical mastectomy. The associated post-operative morbidity was also compared between the two groups. Methods: 40CNB (Core Needle Biopsy) proven cases of locally advanced breast cancer were randomized. (Using randomly ordered sealed envelopes, which were opened immediately before the closure of the wound) in to 20 patients with vacuum sealing drainage dressing (pressure = 350 g/m2) and 20 cases in negative suction drainage dressing groups in The First Affiliated Hospital of Soochow University Ward 6 Department of General Surgery. The two groups were comparable in respect of age, weight, technique of operation, extent of axillary dissection and drainage of serous fluid. Surgery was performed by the same surgical team comprising of five surgeons (two senior and three resident surgeons) using a standardized technique with electro cautery. External compression dressing was provided over the axilla for first 48 hrsand following that patients were encouraged to do active and passive shoulder exercises. The outcomes measured were post-operative morbidity and the length of hospital stay. Statistical methods used: Descriptive studies were performed with SPSS version 10 and group characteristics were compared using student t-test. Results: Vacuum sealing drainage dressing were removed earlier than the negative suction drainage dressing. There was a significant reduction in the total hospital stay in patients with vacuum sealing drainage dressing systems as compared to the negative suction drainage dressing method(p<0.032) without any added morbidity. By using vacuum sealing drainage dressing on old age women, we have found that there is reduced complication of respiratory distress and cardiovascular problems, therefore it maintains the hemodynamic stability. Continuous negative suction pressure creates a negative pressure environment within the wound cavity, which makes the inner walls of the wound become tightly adherent to each other. Thus, after the removal of the VSD dressings, we found the wound cavities to be completely closed and healing very rapidly. Conclusions: Vacuum sealing drainage dressing provide an effective solution over negative suction drainage after modified radical mastectomy and reducing the hospital stay and the post-operative morbidity including postoperatives eroma complication.
Authors and Affiliations
Dr Ninad Vitthal Yeolkar
Keywords
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