Urban Myths in Plastic Surgery: Postoperative Management of Surgical Drains
Introduction
Plastic surgery, like any medical field, is surrounded by numerous myths and misconceptions. One area that often sparks debate is the postoperative management of surgical drains. Dr. Emily Borsting, alongside her colleagues, has delved into this topic in their published paper, "Urban Myths in Plastic Surgery: Postoperative Management of Surgical Drains," to shed light on evidence-based practices.
Background
Surgical drains are commonly used in plastic surgery to prevent fluid accumulation in the surgical site, which can lead to complications such as hematomas, lymphoceles, or seromas. These drains play a crucial role in promoting wound healing and reducing the risk of infection.
Objective of the Study
The primary goal of this paper was to investigate the criteria for removing surgical drains. The authors sought to understand the origins and justification for the commonly used volume-based criteria and explore whether other factors, such as the duration of drain use or the specific characteristics of the surgical site, should influence these recommendations.
Methods
To gather comprehensive data, the researchers performed a literature review, examining various studies on drain removal in reconstructive and breast surgeries. They used search terms related to drain removal, hematomas, lymphoceles, seromas, and surgical reconstruction, covering clinical trials, retrospective reviews, meta-analyses, and literature reviews.
Findings
The findings revealed that most plastic surgeons base drain removal on daily output volume. However, there is also evidence supporting early, fixed-duration drain removal. Key insights include:
Volume Criteria: Patients with higher fluid output from the surgical site tend to continue producing large volumes post-drain removal, suggesting a need for longer drain use.
Surgical Site Characteristics: The surface area of the surgical site can influence the decision on when to remove drains.
Infection Rates: Interestingly, drain-associated infection rates are generally low and seem unaffected by the duration of drain use. However, implementing antisepsis strategies can mitigate poor outcomes such as implant loss or the need for reoperation.
Conclusion
The paper concludes that while volume-based criteria for drain removal are widely accepted, considering other factors such as the surgical site area and potential infection risks can lead to better patient outcomes. Adopting comprehensive antisepsis strategies remains crucial in postoperative care.
