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Superior Pedicle Breast Reduction Techniques Increase the Risk of Postoperative Drainage

Anzarut, Alexander MD, MSc*; Edwards, David C. MD, FRCSC; Calder, Kevin MD; Guenther, Craig R. MD, FRCPC§; Tsuyuki, Ross PharmD, MSc, FCSHP

doi: 10.1097/SAP.0b013e31812f7ba7
Breast Surgery
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Background: The most frequent complication after bilateral reduction mammoplasty (BRM) is the formation of seromas and hematomas. If a group of patients who are at increased risk of seroma and hematoma are identified, the use of drains in this group would be beneficial. We hypothesized that superior pedicle reductions would have increased postoperative drainage.

Methods: A prospective observational study was conducted to identify independent risk factors for increased drainage after BRM. Blinded research nurses were employed to record the amount of drainage during the postoperative period. Univariate and multivariate regression analyses were used to identify risk factors for increased postoperative drainage.

Results: The study included a total of 111 patients. Univariate analysis identified the amount of preoperative infiltration (P < 0.001), the amount of liposuction (P < 0.001), the amount of surgically resected tissue (P = 0.001), the type of reduction (P < 0.001), the patient's chest circumference (P = 0.035), and the patient's body mass index (BMI) (P = 0.015) as significant predictors of postoperative drainage. Multivariate regression analysis identified the amount of tissue resected and the type of reduction as the only 2 independent predictors of postoperative drainage. The use of superior pedicle technique predicted 43% of the variability in postoperative wound drainage.

Conclusions: The use of the superior pedicle technique for BRM is associated with a significant increase in postoperative drainage. Surgeons using this technique should consider the routine use of drains to avoid possible complications of seroma, infection, and poor wound healing.

From the *Division of Plastic and Reconstructive Surgery, Epidemiology Coordinating and Research (EPICORE) Centre, University of Alberta, Edmonton, Alberta, Canada; †Division of Plastic and Reconstructive Surgery, University of Alberta, Edmonton, Alberta, Canada; ‡Division of Plastic and Reconstructive Surgery, Dalhousie University, Halifax, Nova Scotia, Canada; §Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada; and ¶Division of Cardiology, Epidemiology Coordinating and Research (EPICORE) Centre, University of Alberta, Edmonton, Alberta, Canada.

Received May 12, 2007 and accepted for publication June 1, 2007.

Reprints: Alexander Anzarut, MD, MSc, Division of Plastic and Reconstructive Surgery, Epidemiology Coordinating and Research (EPICORE) Centre, 220 College Plaza, University of Alberta, Edmonton, Alberta T6G 2C8 Canada. E-mail: aanzarut@ualberta.ca.

© 2008 Lippincott Williams & Wilkins, Inc.