Drainless perforator flap reconstruction in breast conserving surgery in daycare

Abstract

BACKGROUND Patients treated with breast conserving surgery show at least equal overall survival and superior quality of life than patients treated with mastectomy. Still, in the Netherlands >30% of women with breast cancer undergo a mastectomy. Partial breast reconstruction aims to provide better esthetic outcomes, quality of life and patient satisfaction in large breast tumors, preventing mastectomy. This can be achieved, among other techniques, using chest wall perforator flaps. Drain use often combined with overnight hospital stay used to be common practice. The aim of this study is to investigate whether omitting drains following chest wall perforator flaps reconstruction in daycare is safe regarding postoperative complications. Secondary outcome is patient satisfaction as reported in the Breast-Q questionnaire. METHODS 36 patients were included for this retrospective study. Data was extracted from the electronic patient record. Breast-Q questionnaires were sent to patients. Complications were scored according to Clavien-Dindo after 30 days, 60 days and 6 months. Results were compared with literature. RESULTS Overall complication rate was 41,7% after 30 days, 25% after 60 days and 13,9% after 6 months. The Breast-Q response rate was 66,7%. Breast-Q scores were: psychosocial well-being 83, satisfaction with breast 80 and physical well-being 75. DISCUSSION The results of this study were similar to results found in previous studies. Breast conserving surgery with partial breast reconstruction using chest wall perforator flaps without using suction drains in daycare treatment is feasible.