COMPARISON OF SINGLE-DRAIN AND DOUBLE-DRAIN PLACEMENT AFTER MODIFIED RADICAL MASTECTOMY IN BREAST CANCER PATIENTS

Abstract

Background: Seroma formation is a prevalent postoperative consequence after Modified Radical Mastectomy (MRM), frequently resulting in discomfort, delayed wound healing, extended hospital stays, and heightened healthcare demands. Diverse techniques have been employed to mitigate seroma, including the quantity of suction drains positioned in the axilla.

Aims: To compare postoperative outcomes between single-drain and double-drain insertion following Modified Radical Mastectomy for breast cancer.

Materials and Methods: This prospective comparative study was conducted over a period of 10 months in the Department of General Surgery. A total of 60 female patients undergoing MRM for operable breast cancer were enrolled and divided into two equal groups of 30 each: Group A received a single closed-suction drain, while Group B received two closed-suction drains. Data collected included demographic characteristics, tumor stage, intraoperative details, daily drain output, total drainage volume, duration of drain retention, postoperative pain scores, seroma formation after drain removal, surgical site infection, flap necrosis, hematoma, and hospital stay. Seroma was clinically diagnosed and confirmed by ultrasound when necessary. Statistical analysis was performed using appropriate tests, and a p-value <0.05 was considered statistically significant.

Results: The mean age, tumor attributes, and surgical length were similar across the two groups. The total drain production and length of drain retention were markedly elevated in the double-drain group (p<0.05). Seroma development occurred more frequently in the single-drain group, although the difference lacked statistical significance. Postoperative pain levels were elevated in the double-drain cohort over the initial two postoperative days (p<0.05). The occurrence of wound infection, flap necrosis, and hematoma exhibited no significant disparity across the groups. The duration of hospitalization was marginally extended for patients with double drainage.

Conclusion: Single-drain insertion after MRM has comparable surgical results to double-drain installation, while offering benefits such as diminished pain, decreased drainage burden, and a shorter hospital stay. Double draining may not markedly diminish seroma production and may exacerbate discomfort. Consequently, single drainage seems to be a secure and efficient alternative in standard practice.