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Background <p>Closed-suction drains are routinely used in breast reconstruction, but evidence regarding early removal remains limited. This study evaluated whether early drain removal affects local wound complications.</p> Methods <p>We retrospectively reviewed patients who underwent breast reconstruction with tissue expanders (TE), implants, or autologous tissue between January 2019 and August 2024. Patients were divided into two groups: a volume-based group (drains removed when output &lt; 30&#xa0;mL/24&#xa0;h) and an early-removal group (drains removed within 4&#xa0;days postoperatively). Incidences of seroma, surgical site infection (SSI), and implant removal within one year postoperatively were compared.</p> Results <p>A total of 265 reconstructions in 241 patients were analyzed (134 volume-based, 131 early-removal). Seroma incidence was similar between groups. However, SSI occurred significantly less frequently in the early-removal group than in the volume-based group (21/134 (15.7%) vs. 9/131 (6.9%), p = 0.032). This reduction was evident only in TE/implant-based reconstructions. Multivariable analysis identified early drain removal as an independent protective factor against SSI (OR, 0.316; p = 0.015).</p> Conclusions <p>Early drain removal within 4&#xa0;days does not increase seroma risk and is associated with a significantly lower SSI rate in TE/implant-based breast reconstruction. These findings suggest early drain removal is both safe and beneficial in selected patients.</p>

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"Safety and efficacy of early drain removal in breast reconstruction: a retrospective cohort study"

  • 期刊论文

  • 发表日期：

    2025年10月16日

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  • Daiju Goto,
  • Azusa Oshima,
  • Tatsuya Onishi,
  • Takuya Higashino

摘要

Background

Closed-suction drains are routinely used in breast reconstruction, but evidence regarding early removal remains limited. This study evaluated whether early drain removal affects local wound complications.

Methods

We retrospectively reviewed patients who underwent breast reconstruction with tissue expanders (TE), implants, or autologous tissue between January 2019 and August 2024. Patients were divided into two groups: a volume-based group (drains removed when output < 30 mL/24 h) and an early-removal group (drains removed within 4 days postoperatively). Incidences of seroma, surgical site infection (SSI), and implant removal within one year postoperatively were compared.

Results

A total of 265 reconstructions in 241 patients were analyzed (134 volume-based, 131 early-removal). Seroma incidence was similar between groups. However, SSI occurred significantly less frequently in the early-removal group than in the volume-based group (21/134 (15.7%) vs. 9/131 (6.9%), p = 0.032). This reduction was evident only in TE/implant-based reconstructions. Multivariable analysis identified early drain removal as an independent protective factor against SSI (OR, 0.316; p = 0.015).

Conclusions

Early drain removal within 4 days does not increase seroma risk and is associated with a significantly lower SSI rate in TE/implant-based breast reconstruction. These findings suggest early drain removal is both safe and beneficial in selected patients.