AB030. SOH25_AB_064. The role of surgical drains in oncologic breast resections: a systematic review

Background: The use of surgical drains is a well-known practice to prevent seroma formation and hematoma. However, the debate is yet to be concluded on the effectiveness and necessity in improving surgical outcomes.

Methods: A systematic review and meta-analysis was conducted to evaluate the role of surgical drains on seroma formation in breast oncologic resections (mastectomy and wide local excision). Databases including PubMed, Cochrane Library, and Embase were searched for relevant randomized controlled trials (RCTs) published up to Jan 2024. A total of six RCTs were identified and included in the synthesis, comparing the use of drains in patients undergoing breast cancer surgery.

Results: The pooled data from the six RCTs, encompassing 1,012 patients, revealed mixed outcomes regarding the benefits of using surgical drains. Three studies demonstrated a significant reduction in seroma formation in the drain group, one study compared the drain use to the no-drain group, while differences were found in the optimal time of drain removal in our RCTs.

Conclusions: The findings suggest that although surgical drains can lower the occurrence of seroma, the possibility of higher postoperative infections should be carefully evaluated. The data indicate that removing drains early leads to an increased occurrence of seroma formation in clinical settings. Consequently, early drain removal does not have any established clinical advantages in these settings, other for reducing hospital stays. Drain treatment following breast surgery can be performed on an outpatient basis if patients are discharged before to postoperative day 3. Additional extensive, multicenter RCTs are necessary to specifically investigate and define the ideal criteria for hospital release and removal of drains.

Keywords: Surgical drains; breast oncologic resections; seroma formation; mastectomy; seroma drainage