Studying How Outpatient Water affEcts Risks With Drains (SHOWER Study) (SHOWER)

This is a prospective randomized, controlled, unblinded, interventional feasibility study to evaluate if showering with post operative drains in place leads to an increase in complications. The patients included in the study will be those undergoing breast reductions and panniculectomies at Geisinger Medical Center. The patients will be randomized post operatively into one of two groups: 1) patients instructed to shower with drains in place, and 2) patients instructed not to shower while they have drains in place.

Study Overview

• Status: Recruiting
• Conditions: Postoperative Complications; Surgical Site Infection; Drain Site Complication; Postoperative Wound Infection
• Intervention / Treatment: Other: Showering; Other: Restriction of Showering

Detailed Description

This is a prospective randomized, controlled, unblinded interventional feasibility trial evaluating the post-operative outcomes of surgical patients undergoing breast reduction or panniculectomy procedures. Approximately 100 eligible subjects will undergo their surgical procedure according to standard clinical guidelines. Unless clinically contraindicated, study surgeons will maintain consistent use of 10 Flat drains for all study participants to prevent any sampling bias.

Immediately after surgery is completed, the study investigator will randomize the subject into one of the 2 study arms. The randomization scheme will control for procedure type.

The study will not be blinded. The randomization assignment will be communicated to the care team and documented in the subject's electronic medical record to ensure that appropriate post-operative instruction is provided to the subject. Subjects will be notified of their study arm assignment at the time they receive their post-operative discharge instruction.

Subjects in both arms will complete a questionnaire related to quality of life post-operatively, as well as daily bathing specifics.

The following statistical methods will be used for the aims:

Aim 1: Collect and describe information related to outcome measures in addition to study data including number eligible, response rates, adherence/compliance rates.

Descriptive statistics will be provided for all study enrollment data, compliance information as well as data collected throughout the study including outcome measures and responses from the satisfaction survey.

Aim 2: To compare the surgical site complication rate of post-operative patients with drains who shower versus those who do not shower.

Complication rates between the two study arms will be compared using chi-squared tests, although these comparisons will not be conclusive since the study isn't powered to assess equivalence.

Aim 3: To compare patient post-operative satisfaction for those who shower versus those who do not shower.

Patient post-operative satisfaction between the two study arms will be compared using chi-squared tests, although these comparisons will not be conclusive since the study isn't powered to assess differences.

• Study Type: Interventional
• Enrollment (Estimated): 100
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Sean Devitt, MD; Phone Number: 570-271-6335; Email: sdevitt@geisinger.edu
• Study Contact Backup: Name: Samantha Crissinger, BS; Phone Number: 570-271-7499; Email: srcrissinger@geisinger.edu

Study Locations

• United States
  • Pennsylvania
    • Danville, Pennsylvania, United States, 17822
      • Recruiting
      • Geisinger Health
      • Contact: Sean Devitt, MD; Phone Number: 570-271-6335; Email: sdevitt@geisinger.edu
      • Contact: Samantha Crissinger, BS; Phone Number: 570-271-7499; Email: srcrissinger@geisinger.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patients having one of the following procedures at Geisinger Medical Center in which drains are placed

  • Breast reduction
  • Lower panniculectomy
  • Fleur-de-lis panniculectomy
• ≥18 years of age
• Able and willing to provide consent

Exclusion Criteria:

• Patients on antibiotics at the time of surgery
• Patients sent home on antibiotics after surgery
• Patients who work in healthcare with direct patient contact
• Patients having a panniculectomy to be eligible for a kidney transplant
• Patients having a ventral hernia repair at the time of the panniculectomy
• Patients admitted to the hospital for >1 night

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Study Arm 1; Subjects assigned to Arm 1 will be instructed to shower daily beginning on post-operative Day 2 and maintain this daily schedule until the subject's 3-month standard of care clinic follow-up visit. They will receive specific instructions on caring for the incision site and drains until they are removed.	Other: Showering; Patients will be instructed to shower after surgery with drains in place
Active Comparator: Study Arm 2; Subjects assigned to Arm 2 will be instructed not to shower post-operatively until their surgical drains are removed. They will receive specific instructions on bathing and caring for the incision sites and drains.	Other: Restriction of Showering; Patients will be restricted from showering post operatively if they have drains in place

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Drain site cellulitis	At each post operative appointment, the patient's drain sites will be examined for signs of cellulitis including tenderness to palpation and blanching erythema. The decision will be based on clinical exam by the physicians assistant, confirmed with the attending physician, and photos will be taken for documentation.	12 weeks
Incisional cellulitis	At each post operative appointment, the patient's incision will be examined for signs of cellulitis including tenderness to palpation and blanching erythema. The decision will be based on clinical exam by the physicians assistant, confirmed with the attending physician, and photos will be taken for documentation.	12 weeks
Seroma formation	At each post operative visit, the patient will be examined to rule out the presence of wound seroma. Any seroma requiring needle aspiration with removal of fluid will be documented as a positive seroma.	12 weeks
Abscess formation	The patient will be examined at each post operative visit. Any collection of bacteria (abscess) that requires bedside drainage will be recorded as an abscess.	12 weeks
Wound dehiscence	Development of wound dehiscence during follow-up period	12 weeks
Patient Satisfaction	Measurement of patient satisfaction of post-operative ability to shower based on administration of a satisfaction survey	12 weeks

Collaborators and Investigators

• Sponsor: Sean Devitt
• Investigators: Principal Investigator: Sean Devitt, MD, Geisinger Clinic

Study record dates

Study Major Dates

• Study Start (Actual): February 23, 2022
• Primary Completion (Estimated): December 15, 2026
• Study Completion (Estimated): July 15, 2027

Study Registration Dates

• First Submitted: January 20, 2021
• First Submitted That Met QC Criteria: January 21, 2021
• First Posted (Actual): January 27, 2021

Study Record Updates

• Last Update Posted (Actual): February 20, 2026
• Last Update Submitted That Met QC Criteria: February 18, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Panniculectomy; Surgical drain; Breast reduction surgery; Postoperative showering; Fleur-de-lis panniculectomy; Massive weight loss surgery
• Additional Relevant MeSH Terms: Pathologic Processes; Infections; Wound Infection; Pathological Conditions, Signs and Symptoms; Surgical Wound Infection; Postoperative Complications
• Other Study ID Numbers: 2020-0970

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No