Perceptions of Surgical Drains among Breast Reconstruction Patients and Health Care Staff: A Qualitative Survey Study

Abstract

Background Surgical drains are a key component for recovery in breast reconstruction procedures. However, they are often cumbersome and carry a risk of infection with prolonged use. We aimed to develop a more thorough understanding of patient and health care provider perspectives on surgical drains, to inform future efforts in improving the breast reconstruction patient experience.

Methods Twenty-nine breast reconstruction patients and eight plastic surgery providers were recruited to complete surveys focused on surgical drains. Likert scales ranging from 1 to 5 were developed to gauge how bothersome drains felt, as well as concern for infection. Ordinal variable and categorical multiple-choice analyses were applied as appropriate.

Results Fifteen (51.7%) patients underwent implant-based breast reconstruction, and 14 (48.3%) patients underwent autologous breast reconstruction. The most common duration of drain placement was 2 weeks (N = 13). The surgical site infection (SSI) rate requiring antibiotics was 28% (N = 8). On a scale of 1 to 5, both patients (median = 3) and providers (median = 2.5) viewed drains as bothersome. Patients were “frequently” concerned about infection risk (median = 3). Other high-frequency patient concerns included general pain and discomfort.

Conclusion Surgical drains are a common component of breast reconstruction procedures and are viewed as cumbersome by both patients and providers. Patients expressed concerns about drain site pain, discomfort, and tugging on clothing. Patients and providers both believed that drains could contribute to SSI. Overall, these data provide insight to drive future improvements in the patient drain experience.

Keywords

plastic surgery - surgical wound infection - mammaplasty - surgical drain

Clinical Trial Registration Information

Not applicable.

Authors' Contributions

W.M.T., J.D.R., R.B., and S.T.H. conceived the idea and study design for this article. W.M.T., B.E.S., J.D.R., K.D., V.N.Y., and M.T. contributed to writing the article. W.M.T. and J.D.R. performed data analysis. J.G. was the research coordinator for the study. All authors contributed to the feedback for the manuscript.

Institutional Review Board

This study was approved by the Duke University Health System Institutional Review Board.

Note

This study was presented at the American College of Surgeons Clinical Congress 2021.

Publication History

Received: 11 February 2024

Accepted: 05 May 2024

Accepted Manuscript online:
23 May 2024

Article published online:
24 June 2024

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