Postoperative Showering for Patients With Closed Suction Drainage: A Retrospective Cohort Study of Deep Inferior Epigastric Perforator Flap Breast Reconstructions

Abstract

Background The deep inferior epigastric perforator (DIEP) flap has been widely used in breast reconstruction. During surgery, many surgeons use closed suction drainage for both the donor site and the reconstructed breast. However, the criteria for drainage removal depend on the surgeon's preference and remain controversial. Moreover, it is well known that early postoperative showering is harmless to the surgical site and is recommended in many reports. However, it has not been discussed whether it is acceptable for patients with closed suction drainage to take a shower. Methodology We conducted a retrospective study of postoperative showering in 30 patients who underwent breast reconstruction with a DIEP flap. During the surgery, a total of three closed suction drains were connected to the patient's body (one was connected to the reconstructed breast, and the other two were connected to the abdominal donor site). After the surgery, patients were allowed to shower when the number of connected drainage tubes was ≤2. Results The patients were divided into three groups according to the number of remaining drainage tubes connected to their bodies when they started postoperative showering. Group A included patients with no drainage tubes. Group B included patients with one remaining drainage tube. Group C included patients with two drainage tubes. No significant differences in the incidence of postoperative individual complications were observed among the three groups. Conclusions Postoperative showering for patients with closed suction drainage is safe and does not increase the incidence of postoperative complications, including surgical site infection.

Keywords: closed suction drainage; complication; deep inferior epigastric perforator flap; shower; surgical site infection.

Conflict of interest statement

The authors have declared that no competing interests exist.

Copyright © 2022, Ogawa et al.

Figures

Figure 1. The setting of the closed suction drainage tube on the patient’s abdominal donor site.

One drainage tube was connected to the reconstructed breast subcutaneously. Two drainage tubes were connected to the patient’s abdominal donor site from each side. Image credits: Haruo Ogawa.

Figure 2. The condition of the closed suction drainage tube dressing.

The insertion site of the drainage tube was covered with IV3000 ported. However, the drain insertion sites were not completely waterproofed.

Figure 3. Box plots showing the ages of the groups.

No significant differences were observed among the groups (p = 0.33).

Figure 4. Box plots of the BMIs of the groups.

No significant differences were observed among the groups (p = 0.61).

Figure 5. Box plots showing the nutritional status of the groups.

No significant differences were observed among the groups (p = 0.59).

Figure 6. Box plots showing intraoperative bleeding volumes.

No significant differences were observed among the groups (p = 0.92).

Figure 7. Box plots showing distributions of the start dates of the postoperative showering.

No significant differences were observed among the groups (p = 0.20).

Figure 8. Box plots showing distributions of the dates of the closed suction drainage removal.

No significant differences were observed among the groups (p = 0.08).