Safety and Efficacy of Percutaneous Drain Placement for Postsurgical Breast Region Fluid Collections.

Abstract

Objective: The purpose of this study was to describe the safety and efficacy of percutaneous drain placement for postoperative fluid collections in the breast.

Methods: A retrospective review was conducted of the patient characteristics, intervention data, and clinical outcomes of the 43 adult patients who underwent percutaneous drain placement for fluid collections at a tertiary care hospital over a 13-year period ending February 28, 2023.

Results: Most fluid collections treated with percutaneous drain placement were secondary to ipsilateral breast surgery (92%, 44/48), most commonly breast reduction (23%, 10/44) and mastectomy with immediate tissue expander reconstruction (16%, 7/44). Additional patients had fluid collections without prior ipsilateral breast surgery (8%, 4/48) and were excluded from further analysis. The fluid cultures from 39% of the cultured postsurgical fluid collections were positive (16/41), and Staphylococcus aureus was the most commonly cultured organism (15%, 6/41). The only immediate complication was the rupture of a tissue expander during drain placement in 1 patient. The median duration of percutaneous drainage for postsurgical fluid collections was 12 days (range: 1 to 49 days). Percutaneous drain placement achieved clinical success without any subsequent treatments in 73% (32/44) of patients. An additional 7% (3/44) of patients required subsequent image-guided aspiration procedures and/or percutaneous drain placements but avoided surgical treatment for a persistent fluid collection.

Conclusion: Postsurgical fluid collections after diverse breast surgeries represented the vast majority of the fluid collections referred to our academic practice for percutaneous drain placement. Percutaneous drain placement was a safe and effective treatment in this patient population.