- Joined
- Sep 12, 2020
the fear of drains seems to be infiltrating the groups more and more, they have their risks and downsides but are usually very effective and tolerable. i just had a very quick peek for evidence of drains Being Good and first cab off the (generally acceptable source) rank says: "Reviews by Kuroi et al. and Srivastava et al. looked at the evidence for the risk factors leading to seroma formation and demonstrated that only obesity and radical type mastectomy were consistently associated with an increased risk of seroma formation".
Mastectomy Without Drains Reduces Cost with No Detriment to Patient Outcome
Introduction Use of drains after mastectomy remains highly variable. This study aimed to establish whether simple mastectomy managed without a drain would cost less than the same procedure managed with a drain and whether there would be ...
www.ncbi.nlm.nih.gov
i read somewhere that dr g, instead of placing drains, uses more internal sutures, closer together, at the fascia layers (something like that) which sure great if thats leading to acceptable outcomes, go for it - experiment away and share your findings in a legit peer-reviewed journal and the technique may become more of a standard in time.
or um just make a tiktok advertising how you don't use drains even on obese people, and profit.
this one is basically "non-use of drain seems mostly ok depending on individual patient risk factors etc" but p.s -
"A body mass index (BMI) > 30 is a well-known risk factor for impaired wound healing after abdominal surgery 33. Similarly, a 12-fold higher risk of complications has been reported for elective breast surgery in women with higher BMI 34, although the majority of cases (80 %) in this study had reduction surgery. Helyer et al. also described an association between obesity and lymphedema 35."
Does Non-Placement of a Drain in Breast Surgery Increase the Rate of Complications and Revisions?
Purpose: Although surgical therapy for breast cancer has become less radical, intrasurgical placement of drains and the use of compression bandages is still standard practice. However, evidence for the clinical benefit of wound drains is controversial, ...
www.ncbi.nlm.nih.gov
the 12-fold risk reported is from this study -
There were 2403 patients in the obese group (breast reduction, 80.7 percent; reconstruction, 10.3 percent; mastopexy with augmentation, 1.5 percent; mastopexy alone, 3.5 percent; and augmentation alone, 4.0 percent). The occurrence of complications was compared for each procedure to a nonobese control group of 5597 patients. Overall, 18.3 percent of obese patients had a claim for a complication, compared with only 2.2 percent in the control group (p<0.001). Obesity status increased the odds of experiencing a complication by 11.8-fold after adjusting for other variables.
i'm sorry but the first comment up there from annalea matthews saying they ALMOST REPORTED A PHYSICIAN FOR NOT DOING A CONSULT IF BMI > 30 is fucking outrageous, i say please do make that report, all of you start reporting then perhaps a fucking grown up can step in and explain to these fuckers that its NOT FUCKING DISCRIMINATION.
