Current practice patterns of drain usage amongst UK and Irish surgeons performing bilateral breast reductions: Evidence down the drain.
INTRODUCTION
Bilateral breast reduction (BBR) is one of the most frequently performed female breast operations. Despite no evidence supporting efficacy of drain usage in BBRs, postoperative insertion is common. Recent high quality evidence demonstrating potential harm from drain use has subsequently challenged this traditional practice. The aim of this study is to assess the current practice patterns of drains usage by Plastic & Reconstructive and Breast Surgeons in UK and Ireland performing BBRs.


METHOD
An 18 question survey was created evaluating various aspects of BBR practice. UK and Irish Plastic & Reconstructive and Breast Surgeons were invited to participate by an email containing a link to a web-based survey. Statistical analysis was performed with student t-test and chi-square test.


RESULTS
Two hundred and eleven responding surgeons were analysed, including 80.1% (171/211) Plastic Surgeons and 18.9% (40/211) Breast Surgeons. Of the responding surgeons, 71.6% (151/211) routinely inserted postoperative drains, for a mean of 1.32 days. Drains were used significantly less by surgeons performing ≥20 BBRs (p = 0.02). With the majority of BBRs performed as an inpatient procedure, there was a trend towards less drain usage in surgeons performing this procedure as an outpatient; however, this was not statistically significant (p = 0.07).


CONCLUSION
Even with the high level of evidence demonstrating the safety of BBR without drains, they are still routinely utilised. In an era of evidence- based medicine, surgeons performing breast reductions must adopt the results from scientific research into their clinical practice.
['Sugrue|Conor M|CM|', 'McInerney|Niall|N|', 'Joyce|Cormac W|CW|', 'Jones|Deidre|D|', 'Hussey|Alan J|AJ|', 'Kelly|Jack L|JL|', 'Kerin|Michael J|MJ|', 'Regan|Padraic J|PJ|']
D000328:Adult D001940:Breast D004322:Drainage D019317:Evidence-Based Medicine D005260:Female D005500:Follow-Up Studies D019538:Health Care Surveys D006801:Humans D007494:Ireland D016462:Mammaplasty D008875:Middle Aged D061214:Patient Safety D011182:Postoperative Care D010818:Practice Patterns, Physicians' D011300:Preoperative Care D066231:Surgeons D011795:Surveys and Questionnaires D016896:Treatment Outcome D006113:United Kingdom
Breast reduction plastic surgery