Effect of low-pressure vacuum suction versus high-pressure vacuum suction in decreasing post-operative axillary drainage and seroma formation following modified radical mastectomy using ultrasonic surgical device

Abstract

Background: Prolonged post-operative wound drainage and subsequent seroma formation are common complications following mastectomy with axillary lymph node dissection (ALND). Ultrasonic surgical devices (USDs) have improved outcomes, and suction drains are routinely used. This study compared low-pressure versus high-pressure vacuum suction drainage to evaluate their additive effect in reducing post-operative complications. Aims and Objectives: The aim was to compare low versus high vacuum suction in decreasing post-operative axillary drainage and seroma formation after modified radical mastectomy (MRM) for locally advanced breast cancer. Objectives included recording daily drainage output, duration of drainage, and incidence of seroma formation. Materials and Methods: A prospective randomized controlled study was conducted in female patients with locally advanced breast carcinoma who had received neoadjuvant chemotherapy and underwent MRM. Axillary dissection was performed using USD. Two 14 Fr suction drains were placed: connected to low-pressure vacuum suction (35 mmHg) in Group A and high-pressure vacuum suction (70 mmHg) in Group B. Daily drainage volumes were recorded. Results: The mean post-operative drainage volume was significantly lower in the low-pressure group (411.72±78.94 cc) compared to the high-pressure group (485.16±105.12 cc; P=0.007). Seroma formation occurred in three patients in Group A and two patients in Group B, with no statistically significant difference (P=0.63). Conclusion: Low-pressure vacuum suction drainage following MRM with ALND using USD significantly reduces total post-operative drainage volume without affecting the incidence of seroma formation, suggesting it as a preferable option for post-operative management.