Journal time!
If anyone has had a surgery with drains, you know they are an experience- a clear tube, coming out of the body, a part which remains inside you to drain fluid. We use them frequently in surgeries like mastectomy and breast reconstruction, some breast reductions, and in abdominoplasty.
When you have a tube running from the outside (not sterile) to the inside of your body you wonder, do bacteria follow the tube? And if so, the question becomes, does the drainage tube cause an increase in infections, particularly when a foreign object like a breast implant or tissue expander is used? And if it is a potential source of issue, could we use something to help block the bacteria, so it wouldn’t be an issue?
This study aims to answer it. “Does the Use of Biopatch Devices at Drain Sites Reduce Perioperative Infectious Complications in Patients Undergoing Immediate Tissue expander Breast Reconstruction? in the January 2015 issue of Plastic and Reconstructive Surgery Journal.
Study: Biopatch disks were used at drain exit sites. A retrospective review of all patients who had tissue expander resconstruction at a single institution. They compared demographics, complications, drain duration, and antibiotic type. 1211 met criteria. The control group was 606.
Findings?
- No statistical difference for minor infection, major infection, need for explant, or mastectomy skin flap necrosis.
- There were correlations with complications and age over 50, diabetes, high blood pressure, high cholesterol, obesity, history of radiation, and mastectomy skin flap necrosis.
Conclusion? Biopatch disks do not reduce the rate of infections.
My thoughts: We are always looking at ways to improve what we do. I believe bacteria and biofilm can be big issues when placing a foreign object like a tissue expander or breast implant into a patient. I thought this study had big numbers (better science conclusions when more data points) and was a good study.