Our Summary

This research paper is about the best ways to deal with wounds after surgery for breast cancer. The most common surgical treatment for breast cancer is a modified radical mastectomy (MRM), which involves removing the main tumor and any nearby tissue that may also be affected.

After this surgery, there can be complications like bleeding, infection, or the buildup of fluid. These issues can often be linked to how the surgical wound is drained. However, there isn’t a standard guide on the best way to drain these wounds, which leaves room for new techniques but also means that different methods need to be compared.

The researchers looked at various factors like the equipment used for drainage, the number and placement of drains, the type of drainage system, when the drains are removed, and alternatives to using drains at all.

Based on their review, the best method seems to be using one drain running from the chest to the armpit with a low level of suction. Ideally, this drain would be removed two or three days after surgery or when the amount of fluid being drained in a day drops below 50 milliliters. This approach appears to lead to the best outcomes for patients, in terms of shorter hospital stays and fewer post-surgery complications.

FAQs

  1. What is a modified radical mastectomy (MRM) and why is it the most common surgical treatment for breast cancer?
  2. What complications can occur after a modified radical mastectomy (MRM) and how are they linked to wound drainage?
  3. What is the best method for draining wounds after a modified radical mastectomy (MRM), according to the research?

Doctor’s Tip

A helpful tip a doctor might tell a patient about radical mastectomy is to carefully follow the post-operative wound care instructions provided by your healthcare team. This may include keeping the surgical site clean and dry, monitoring for signs of infection such as redness, swelling, or discharge, and avoiding activities that could put strain on the surgical area. It’s important to report any concerns or changes in your condition to your healthcare provider promptly.

Suitable For

Patients who are recommended for a radical mastectomy typically have larger tumors or tumors that are in close proximity to the chest wall or surrounding tissue. These patients may also have tumors that are invasive or have spread to nearby lymph nodes. Additionally, patients who have a genetic predisposition to breast cancer, such as those with a BRCA gene mutation, may also be recommended for a radical mastectomy.

Overall, the decision to recommend a radical mastectomy is made on a case-by-case basis by a multidisciplinary team of healthcare providers, including surgeons, oncologists, and radiologists. Factors such as the size and location of the tumor, the type and stage of breast cancer, the patient’s overall health and preferences, and the presence of any other medical conditions all play a role in determining the most appropriate surgical treatment for each individual patient.

Timeline

Before radical mastectomy:

  1. Patient is diagnosed with breast cancer and discusses treatment options with their healthcare provider.
  2. Patient decides to undergo radical mastectomy as a treatment for breast cancer.
  3. Patient undergoes pre-operative preparations, which may include tests, consultations, and instructions on how to prepare for surgery.
  4. Patient undergoes radical mastectomy surgery, which involves removal of the affected breast tissue.
  5. Patient is monitored post-operatively for any complications and begins the recovery process.

After radical mastectomy:

  1. Patient may experience pain, discomfort, and limited arm movement in the days following surgery.
  2. Patient’s surgical wound is monitored for signs of infection, bleeding, or fluid buildup.
  3. Patient may have drains inserted to help remove excess fluid from the surgical site.
  4. Patient is discharged from the hospital and continues to recover at home, following post-operative instructions provided by their healthcare provider.
  5. Patient attends follow-up appointments to monitor healing, discuss any concerns, and receive further treatment if necessary.
  6. Patient may undergo reconstructive surgery or other treatments to address any aesthetic or functional issues resulting from the mastectomy.

What to Ask Your Doctor

Some questions a patient should ask their doctor about radical mastectomy and wound drainage after surgery may include:

  1. What type of drainage system will be used after my surgery?
  2. How many drains will I have and where will they be placed?
  3. How long will the drains need to stay in place?
  4. What signs of complications should I watch for related to the wound drainage?
  5. Are there any alternatives to using drains for wound drainage?
  6. When can I expect to have the drains removed?
  7. How will the removal of the drains be done and will it be painful?
  8. What can I do to care for the wound and drainage site at home?
  9. Will I need any special supplies or equipment for wound care after surgery?
  10. What are the potential risks or complications associated with wound drainage after a radical mastectomy?

Reference

Authors: Stoyanov GS, Tsocheva D, Marinova K, Dobrev E, Nenkov R. Journal: Cureus. 2017 Jul 10;9(7):e1454. doi: 10.7759/cureus.1454. PMID: 28929038