Introduction:
Use of drains is invasive, breaching the skin barrier, leaving a foreign body within
the wound and causing patient discomfort. Monitoring and cleaning of drains and exit
wounds also consumes nursing resources. Elimination of donor site drain use would
be preferable. This study retrospectively assessed the effectiveness of a high strength
lysine-based adhesive in reducing overall invasiveness compared to standard donor
site wound closure with drains in a DIEP Flap Breast Reconstruction Procedure.
Methods:
Data was retrospectively collected for 58 patients, meeting the inclusion/exclusion
criteria, who underwent a DIEP flap breast reconstruction procedure with standard
donor site wound closure with drains (SWC) or with TissuGlu® and no drains (TissuGlu).
Exclusion criteria included current smoker, BMI> 28 and active SSRI drug prescriptions.
The primary outcome measured assessed overall invasiveness using the number of fluid
related clinical interventions, including drain use and needle aspirations. Secondary
endpoints included total wound drainage, cumulative days of treatment, and length
of hospital stay.
Results:
See table below. (Mean ± SD)
|
Number of fluid related clinical interventions
|
2.0 ± 0.4 (59 total interventions)
|
0.2 ± 0.5 (5 total interventions)
|
< 0.0001
|
|
Total wound drainage (mL)
|
335.5 ± 179.4
|
13.8 ± 52.7
|
< 0.0001
|
|
Cumulative days of invasive treatment
|
6.2 ± 1.5
|
0.2 ± 0.6
|
< 0.0001
|
|
Post-op length of hospital stay (days)
|
8.3 ± 1.3
|
7.9 ± 1.8
|
0.0930
|
|
Overall Results – second column describes the Control Group (n = 29), third column
shows the TissuGlu Group (n = 29), forth column reports the p-value
|
Conclusion:
The study shows that the drain-free donor site DIEP flap procedure is a less invasive
and more patient friendly alternative to the conventional method with drains. A prospective,
randomized study would be an appropriate next step.
