Single Versus Double Drains After Mastectomy

NCT ID: NCT02202252

Last Updated: 2015-04-10

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-07-31

Study Completion Date

2015-02-28

Brief Summary

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It is not known whether decreasing the number of drains used decreases patients' discomfort and duration of hospital stay without increasing seroma formation after mastectomies.

Hypothesis. Use of one drain increases patient comfort without increasing seroma formation after modified radical mastectomy (MRM) as compared to double drains.

Material and Method: Sixty patients undergoing MRM at Diskapi Yildirim Beyazit Training and Research Hospital will be randomised into single versus double drains groups. A negative pressure drain will be inserted below the lower flap directing to the axilla in the single drain group or two similar drains will be inserted into the axilla and below the lower flap in the double drains group. Drains will be removed if the output is less than 30 ml. Seroma is defined as fluid accumulation below the flaps and will be examined daily after the operation. One day after removal of the drains seroma under the flaps and in the axilla will be examined by ultrasonography. Age, body mass index smoking history, coexisting diseases of the patients duration of the hospital stay, duration of the drains in place, total drain output in the first three days after the operation and the need and frequency of aspirations due to seroma formation will be recorded. Patient comfort was measured with a comfort scale between 1-10 measuring incisional pain, pain caused by the drains, discomfort or sleep disturbances caused by the drains, The duration of the longer staying drain in the double drain group will be recorded for the duration of the drain in place parameter.

Detailed Description

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Background: Seroma is one of the most common complications after mastectomies. Seroma formation results in delays in wound healing, incisional dehiscence, infections and long hospital stay. Although there are studies proving that drains do not prevent seroma formation, the use of drains for that purpose is still very common. Decreasing the number of drains used after mastectomies has been shown to decrease patients' discomfort and duration of hospital stay without increasing seroma formation.

Objective: To investigate the effects of single versus double drains on patient comfort and seroma formation after modified radical mastectomy (MRM) Material and Method: Sixty patients undergoing MRM at Diskapi Yildirim Beyazit Training and Research Hospital will be randomised into single versus double drains groups. A negative pressure drain will be inserted below the lower flap directing to the axilla in the single drain group or two similar drains will be inserted into the axilla and below the lower flap in the double drains group. Drains will be removed if the output is less than 30 ml. Seroma is defined as fluid accumulation below the flaps and will be examined daily after the operation. One day after removal of the drains seroma under the flaps and in the axilla will be examined by ultrasonography. Age, body mass index smoking history, coexisting diseases of the patients duration of the hospital stay, duration of the drains in place, total drain output in the first three days after the operation and the need and frequency of aspirations due to seroma formation will be recorded. Patient comfort was measured with a comfort scale between 1-10 measuring incisional pain, pain caused by the drains, discomfort or sleep disturbances caused by the drains, The duration of the longer staying drain in the double drain group will be recorded for the duration of the drain in place parameter. Two groups will be compared with chi-square, student's t-test or Mann-Whitney U test. P\<0.005 will be considered as significant.

Conditions

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Breast Cancer Mastectomy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Single drain

Insertion of a single drain: A negative pressure drain will be inserted below the lower flap directing to the axilla in the single drain group.

Ultrasonography after removal of the drains: One day after removal of the drains seroma under the flaps and in the axilla will be examined by ultrasonography.

Group Type EXPERIMENTAL

Insertion of a single drain

Intervention Type PROCEDURE

A negative pressure drain will be inserted below the lower flap directing to the axilla.

Ultrasonography after removal of the drains

Intervention Type PROCEDURE

One day after removal of the drains seroma under the flaps and in the axilla will be examined by ultrasonography.

Double drain

Insertion of double drains: Two negative pressure drains will be inserted into the axilla and below the lower flap in the double drains group.

Ultrasonography after removal of the drains: One day after removal of the drains seroma under the flaps and in the axilla will be examined by ultrasonography.

Group Type EXPERIMENTAL

Insertion of double drains

Intervention Type PROCEDURE

Two drains will be inserted into the axilla and below the lower flap in the double drains group.

Ultrasonography after removal of the drains

Intervention Type PROCEDURE

One day after removal of the drains seroma under the flaps and in the axilla will be examined by ultrasonography.

Interventions

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Insertion of a single drain

A negative pressure drain will be inserted below the lower flap directing to the axilla.

Intervention Type PROCEDURE

Insertion of double drains

Two drains will be inserted into the axilla and below the lower flap in the double drains group.

Intervention Type PROCEDURE

Ultrasonography after removal of the drains

One day after removal of the drains seroma under the flaps and in the axilla will be examined by ultrasonography.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Breast cancer
* Modified radical mastectomy

Exclusion Criteria

* Distant metastasis
* Male breast cancer
* Bleeding diathesis
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Ankara Diskapi Training and Research Hospital

OTHER

Sponsor Role lead

Responsible Party

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Melih Akinci

Melih Akinci

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Diskapi Training and Research Hospital

Ankara, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Akinci M, Cetin B, Aslan S, Kulacoglu H. Factors affecting seroma formation after mastectomy with full axillary dissection. Acta Chir Belg. 2009 Jul-Aug;109(4):481-3. doi: 10.1080/00015458.2009.11680464.

Reference Type BACKGROUND
PMID: 19803259 (View on PubMed)

Aitken DR, Minton JP. Complications associated with mastectomy. Surg Clin North Am. 1983 Dec;63(6):1331-52. doi: 10.1016/s0039-6109(16)43192-0. No abstract available.

Reference Type BACKGROUND
PMID: 6359504 (View on PubMed)

Jain PK, Sowdi R, Anderson AD, MacFie J. Randomized clinical trial investigating the use of drains and fibrin sealant following surgery for breast cancer. Br J Surg. 2004 Jan;91(1):54-60. doi: 10.1002/bjs.4435.

Reference Type BACKGROUND
PMID: 14716794 (View on PubMed)

Talbot ML, Magarey CJ. Reduced use of drains following axillary lymphadenectomy for breast cancer. ANZ J Surg. 2002 Jul;72(7):488-90. doi: 10.1046/j.1445-2197.2002.02456.x.

Reference Type BACKGROUND
PMID: 12123509 (View on PubMed)

Saratzis A, Soumian S, Willetts R, Rastall S, Stonelake PS. Use of multiple drains after mastectomy is associated with more patient discomfort and longer postoperative stay. Clin Breast Cancer. 2009 Nov;9(4):243-6. doi: 10.3816/CBC.2009.n.041.

Reference Type BACKGROUND
PMID: 19933080 (View on PubMed)

Other Identifiers

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DGC-45

Identifier Type: -

Identifier Source: org_study_id

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