Use of drain versus no drain after mastectomy: a systematic review

Use of drain versus no drain after mastectomy: a systematic review

Authors

  • Letícia Meneses Teixeira Faculdade Ciências Médicas de Minas Gerais   Author
  • Fernanda Kato Diláscio Faculdade Ciências Médicas de Minas Gerais   Author
  • Gabriel Pereira Martins Faculdade Ciências Médicas de Minas Gerais   Author
  • Guilherme Starling Moss PUC Minas Gerais   Author

DOI:

https://doi.org/10.51473/rcmos.v1i1.2025.915

Keywords:

Mastectomy. Surgical drain. Seroma. Quilting sutures. Postoperative complications.

Abstract

To evaluate the effectiveness and safety of surgical drains compared to no drains in patients undergoing mastectomy, focusing on seroma formation, infection, recovery time, and secondary procedures. This systematic review followed PRISMA guidelines. A comprehensive search was conducted in PubMed from 2018 to 2025. Included studies were randomized clinical trials, systematic reviews, meta-analyses, and comparative observational studies directly assessing the use or absence of drains after mastectomy. Twelve studies were included. Drains reduced the incidence of large seromas and the need for postoperative aspirations in the early days. However, no-drain techniques using flap fixation or quilting sutures showed similar complication rates, with improved patient comfort and shorter hospitalization. Surgical drains are still effective in managing early postoperative seroma, but modern techniques without drains can be equally safe. The choice should consider surgical technique, patient profile, and institutional protocols.  

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Author Biographies

  • Letícia Meneses Teixeira, Faculdade Ciências Médicas de Minas Gerais  

    Faculdade Ciências Médicas de Minas Gerais  

  • Fernanda Kato Diláscio, Faculdade Ciências Médicas de Minas Gerais  

    Faculdade Ciências Médicas de Minas Gerais  

  • Gabriel Pereira Martins, Faculdade Ciências Médicas de Minas Gerais  

    Faculdade Ciências Médicas de Minas Gerais  

  • Guilherme Starling Moss, PUC Minas Gerais  

    PUC Minas Gerais  

References

DE ROOIJ, L. S. et al. Quilting sutures to prevent seroma formation after mastectomy: a systematic review and meta-analysis. European Journal of Surgical Oncology, v. 47, n. 7, p. 1700–1708, 2021.

DOELLO, M. et al. Surgical drain placement in breast cancer: is it always necessary? Breast Care, v. 16, n. 1, p. 79–85, 2021.

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FOULON, A. et al. Comparative analysis of quilting suture versus conventional closure in mastectomy: a prospective randomized study. Annals of Surgical Oncology, v. 30, n. 6, p. 3137–3145, 2023.

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RAO, R. et al. Selective drainage following mastectomy based on risk stratification: a prospective cohort study. World Journal of Surgery, v. 46, n. 5, p. 1065–1071, 2022.

SHIMA, H. et al. The role of closed suction drains following modified radical mastectomy: a randomized prospective trial. Archives of Breast Cancer, v. 8, n. 4, p. 305–311, 2021.

SOLTANI, S. et al. Drain vs. no drain after breast surgery: a systematic review and meta-analysis. International Journal of Surgery, v. 92, p. 106036, 2022.

TAMMINEN, A. et al. Risk factors and consequences of surgical site infection after mastectomy: a population-based cohort study. Breast, v. 69, p. 190–196, 2025.

VELOTTI, N. et al. Impact of quilting sutures on seroma formation after mastectomy: systematic review and meta-analysis. Updates in Surgery, v. 73, n. 4, p. 1505–1513, 2021. DOI: https://doi.org/10.1007/s13304-021-01049-9

Published

2025-04-07

How to Cite

TEIXEIRA, Letícia Meneses; DILÁSCIO, Fernanda Kato; MARTINS, Gabriel Pereira; MOSS, Guilherme Starling. Use of drain versus no drain after mastectomy: a systematic review: Use of drain versus no drain after mastectomy: a systematic review. Multidisciplinary Scientific Journal The Knowledge, Brasil, v. 1, n. 1, 2025. DOI: 10.51473/rcmos.v1i1.2025.915. Disponível em: https://submissoesrevistacientificaosaber.com/index.php/rcmos/article/view/915.. Acesso em: 24 apr. 2025.

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